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 info@nobaddaysfoundation.com 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)