Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with The Assistance Fund before sending sensitive documents. FaxFlow is not affiliated with this organization.
The Assistance Fund fax number
(833) 789-1228
Patient Enrollment and Financial Assistance
Used for: Provides financial assistance for prescription co-pays and other health-related expenses through disease-program-specific funding; enrollment can be online or via paper application (paper forms available by request).
Fax destination details
- Department
- Patient Enrollment and Financial Assistance
- Purpose
- Provides financial assistance for prescription co-pays and other health-related expenses through disease-program-specific funding; enrollment can be online or via paper application (paper forms available by request).
- Form
- Enrollment form (online via Patient Portal) and paper enrollment form (requestable by phone). — Enrollment Application
- Address
- 8427 Southpark Circle, Suite 100, Orlando, FL 32819, USA
- Voice phone
- (855) 845-3663
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Submit a completed enrollment application with required HIPAA release; wait for status; reenrollment occurs annually; paper applications available by request. See TAFCares enrollment hub and provider PDFs for details.
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