Apply to CICRF for financial help

Begin your application process for the Catastrophic Illness in Children Relief Fund (CICRF).

Catastrophic Illness in Children Relief Fund (CICRF)

The Details

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:

Contact the Catastrophic Illness in Children Relief Fund at (800) 882-1435 or (617) 624-6060. TTY users, call (617) 624-5992.

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.

Next steps

Confirmation

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.

More info

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:

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