Patient Application Form
Download the form, fill it out completely and email it to:
or mail to:
- Setting Them Free
- 601 S. Windsor
- Mesa, AZ 85204
Your application will be reviewed and you will be contacted within 2 days by a representative of Setting Them Free.
After acceptance, we will need:
- A quality digital photo of the upper body and other photos you may want to include in your fundraising site.
- Your medical story and why you have a financial need. This will be posted on your fundraising site also. Don’t worry, we will help you edit your story, if requested.
President of Setting Them Free