The Gateway Area Chapter of the National Multiple Sclerosis Society offers financial assistance and promotes independence through financial assistance guidance, direct financial assistance, and referrals. Below are links to the set of the financial assistance forms required by the chapter in order to consider someone for the program.
- Please complete and sign the Financial Assistance Application, and return it to our office. The information will help determine the amount of financial assistance we can provide and will be kept confidential.
- Please have your physician complete and verify the Multiple Sclerosis Diagnosis Confirmation Form and return it to our office.
- Should you need assistance with equipment, we require a prescription on a prescription pad or letterhead from a physician for the requested equipment.
Forms can be mailed or faxed to:
National Multiple Sclerosis Society, Gateway Area Chapter
1867 Lackland Hill Parkway
St Louis, MO 63146
If you have any questions, please contact us at 1-800-344-4867 or 314-781-9020.