Types of Assistance
Rent/Mortgage
Utilities - based on patient's income and amount owed
a bill in the patient's name with the name of the rental/mortgage or utility company and amount
Need to be sent along with the application. If the utility bill is not in their name they need to provide
proof they live at the residence.
Gas Card
Grocery gift cards
Medications -based on income, and cost of medication needed
Transportation - 1 month of access lynx bus passes or private transportation
based on availability and schedule of Dialysis patients. Private transportation is only available to patients that are not in wheelchairs.
Instructions for filling out Application
Visit our website at www.michalshope.org
Click the application for assistance tab under the more tab
You may download the application, print and email back or print and fill out, ( if you do not have access to a printer please ask
your social worker to print for you)
Your application may be scanned and emailed back to us at michalshope@gmail.com or mailed to 3019
Edgewater Dr. Suite 2054 Orlando, FL 32804
Patients may apply for as many services as they need, but may not be approved for all. Approval is based
upon resources available at the time. Patients are allowed to apply once every quarter (3 months from the
previous date they applied)