Tuberculosis (TB) Treatment Assistance Program - Funding and Special Requests
Sometimes, it may be appropriate to provide more treatment assistance aids for a patient than the indicated capped rates (above) if:
- They have a particular need.
- They are contagious and will need to remain in isolation for an extended period.
- They need help paying rent so as not to become homeless.
- They have reached an important milestone in treatment (e.g. completed one year of therapy for multidrug-resistant TB).
Any Treatment Assistance above the capped amount must be approved in advance by the American Lung Association. Contact the American Lung Association’s TB Treatment Assistance Program Coordinator, Michelle Mercure at 262-703-4845 or [email protected] to ensure the availability of funding to fulfill your request. Then, complete and submit the special request form.
First-Time Special Requests: a completed W-9 is required for all check requests. Please submit completed W-9 along with the Special Request Form.