Learn more about
Financial Assistance Programs
Please fill out this brief survey to gain access to the financial assistance resources. Please note, you may experience a “waiting list”, for The Assistance Fund, as funding is limited and will be periodically reimbursed.
First Name
Last Name
Email
How do you relate to the conditions we advocate for?
Patient
Family or Friend of a patient
Caregiver of a patient
Medical Professional
What is your condition of interest?
GBS
CIDP
MMN
Miller Fisher
MMN Variant
Undiagnosed
None
Year Diagnosed:
Contact Information
