Thalidomide Survivors Contribution Program

I got a payment from the Extraordinary Assistance Plan in 1991

Reassessment Application

Consent to Release Medical Information – Reassessment

Ongoing Support Payment Form

Extraordinary Medical Assistance Fund (”EMAF”) Application

Schedule of Possible Eligible Expenses

Appeal of Assessed Disability Level Decision Form

I did not get a payment from the Extraordinary Assistance Plan in 1991 but have since been qualified by the Administrator

 

For further information regarding the Assessment Forms please contact the Administrator.

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