Apply to CICRF for financial help
Catastrophic Illness in Children Relief Fund (CICRF)
What you need
Download the application form: CICRF Application for Assistance
- The information on this application is needed to determine if you are eligible for financial reimbursement from the CICRF.
- You may send us your application now and send the needed documentation of income and expenses as you gather them, or you may send all of it to us at the same time.
To request that an application be mailed to you:
How to apply
Mail your completed application to:
Catastrophic Illness in Children Relief Fund
MA Department of Public Health
250 Washington St., 5th Floor
Boston, MA 02108-4619
To maintain confidentiality, the completed application form cannot be transmitted electronically or faxed.
You will be sent a letter confirming that we have received your application with forms to sign and return. If you do not receive a letter, contact the Catastrophic Illness in Children Relief Fund at at (800) 882-1435 or (617) 624-6060. TTY users, call (617) 624-5992.
Applications are processed in the order they are received. Fund staff will contact you directly when your application has been opened to discuss any additional information needed to determine your eligibility to receive financial assistance.
If you have questions or need help completing the application, please contact the Catastrophic Illness in Children Relief Fund: