No Bad Days Foundation

1990 W. New Haven Ave., Suite 201
Melbourne, FL 32904

321 255-2332 * 321 255-2351 (Fax)

Medical Necessity Request Form

To request assistance from the No Bad Days Foundation for a medical necessity that insurance has refused coverage, please fill out the Medical Necessity Request Form, which you can download below, and return it to us at or by facsimile to (321) 255-2351.  You can also contact Mark Warzecha or Courtney Strus at (321) 255-2332 with any questions or comments.

Medical Necessity Request Form (Download)