210.237.4400          

 
 

Apply for Assistance

 

Applicants must be citizens of the United States or non-citizens lawfully in the United States and reside in the state of Texas.

Los solicitantes deben ser ciudadanos de los Estados Unidos o no ciudadanos legalmente en los Estados Unidos y residir en el estado de Texas.


Begin the process here by downloading and submitting an application. - Comience el proceso aquí descargando y enviando una aplicación.

Download and Complete a Full Application.

Follow all instructions completely and mail in the completed application to the address listed on the form. 

DOWNLOAD FULL APPLICATION

Descarga y Completa una Solicitud Completa.

Siga todas las instrucciones y envíe por correo la solicitud completa a la dirección que figura en el formulario. 

DESCARGAR APLICACIÓN COMPLETA

 

 

 

 

We help amputees throughout the state of Texas who are uninsured or under insured.
To see if you qualify, begin our online process or call us at 210.237.4400

APPLY FOR ASSISTANCE

CONTACT US


 

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