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To Those In need, We are here for you.
The Avamar Foundation is ready to serve you!
If you meet the qualifications below, and are in need of financial
help for medications, please follow the steps below.
Must be 55 years or older
Must reside and receive treatment in our community
Must be unable to afford the cost of medications
Must Provide low income documentation
(Federal Income Tax, W-2’s, S-1099, etc.)
Fill out page 1 and sign/date.
Take form to your Doctor and have them fill out the bottom of page 2
You or your Doctor can fax the form to 330-372-7480
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