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Enrolling for Assistance
Immune Recovery Foundation (IRF) provides service and navigation support for patients who are in need. IRF has streamlined its enrollment process so patients can receive determination of eligibility for program assistance. Click through the tabs for important information and to apply today.
Patient Portal
When our Patient Portal is complete, you will be able to login online to upload your Enrollment and other Forms and to see up-to-date information about your IRF status.
Welcome to Immune Recovery Foundation, a non-profit organization whose support assistance programs provide individuals diagnosed with life-altering diseases the opportunity to get the aid and treatments they need to help improve their quality of life.
In order for us to begin the process of qualifying you for support assistance, please read the following information and then click the APPLY Tab to complete the online application.
Upon receipt of your submitted application, Immune Recovery Foundation will determine if you are eligible for our programs assistance based on our Program Guidelines. To verify household size and household income Immune Recovery Foundation may perform a soft inquiry with a third-party vendor in order to determine eligibility. This inquiry can only be viewed by you (the patient) on your credit history and will not affect your credit score. We will advise you of the final outcome.
If you qualify, we will provide you with support service assistance through our programs.
Please understand that all approvals are on a first-come, first-served basis. Receipt of application does not guarantee program support.
Please call us toll-free at 800-821-1230 if you have any questions or need assistance filling out the following enrollment forms.
Sincerely,
Immune Recovery Foundation,
A National 501(c)(3) Non-Profit Organization
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- Patient must be diagnosed with a covered disease and program must be accepting enrollments.
- Patient must have a valid Social Security number to apply for assistance and receive treatment in the United States.
- Patient must be seeking navigation and other assistance for treatment or services covered diseases
- Patient is required to have valid insurance coverage.
- Patient income level must meet program guidelines.
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- Patient contact and demographic information
- Health insurance information
- Diagnosis and medication
- Prescribing physician’s name and phone number
- Estimate of patient’s household income and household size
If you have read the enrollment information and have all the documents/information ready, click below to complete the enrollment form:
Enrollment Form
Don't avoid necessary medical treatment due to financial needs. Let us help.
LEARN MOREIt's not just about the finances...education can make a big difference.
Learn more about the diseases that have a major impact on the lives of African Americans, Hispanics and other patients of color.
OFFICE LOCATION
10015 Old Columbia Road
Suite B215
Columbia, MD 21046
PHONE
800.821.1230
CONNECT WITH US
Immune Recovery Foundation™ is a tax exempt, independent 501(c)(3) non-profit organization. EIN: 85-2731880
2020 IMMUNE RECOVERY FOUNDATION™ | PRIVACY POLICY | TERMS OF USE