01. Edit your marilyn westbrook garment fund online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send garmentfund via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out garmentfund with our platform
Ease of Setup
DocHub User Ratings on G2
Ease of Use
DocHub User Ratings on G2
Click ‘Get Form’ to open the garmentfund application in the editor.
Begin by filling out the cover sheet. Enter your NLN Member Number, name, contact information, and gender. If applicable, include the name of a parent or guardian for minors.
Complete the Financial Need section by providing your annual household income and indicating whether it is from a joint source or individual. Check all applicable income sources.
In the Health Insurance Information section, answer whether you have health insurance and provide details about coverage percentages and deductibles.
Fill out the Brief Patient’s Medical History section with your year of birth, type of lymphedema, and any relevant medical history. Ensure all requested documents are attached.
Lastly, have your NLN-affiliated therapist complete the Medical Necessity Form either online or manually. Ensure they provide all necessary patient information and sign off on their assessment.
Start using our platform today to streamline your garmentfund application process for free!
MediUSAAtlantic Health lymphedema clinicLymphedema practitionersMedical grade compression stockingsMedivenLymphedema SymposiumLymphedema Association of North AmericaMedi online Shop
Related links
Giving to Stony Brook
Your gifts mean so much to our hard-working students and faculty. It means they can think bigger, docHub higher and help create a better world for us all.
Cookie consent notice
This site uses cookies to enhance site navigation and personalize your experience.
By using this site you agree to our use of cookies as described in our Privacy Notice.
You can modify your selections by visiting our Cookie and Advertising Notice.