How Do I Qualify?

You will need to provide documentation from a physician’s office confirming that you are in need of the proposed procedure, along with the form below confirming that the patient is in the correct economic status and qualifies for financial support. (Additional documentation may be required as needed) Once approved, the physician’s office will schedule the procedure within their primary facility of practice. When necessary, PBF may even assist in helping transport the patients to the location of the procedure when they have no alternative options.

Are you a patient in need of elective surgery?

Complete our application to have your procedure qualify for funding by our generous contributors.