A Better Way to Care, Give and Serve
NOTE: Incomplete requests will not be processed. Supporting documentation is required and must be submitted with the application. Examples of documentation include eviction/foreclosure notices, past due utilities, police/fire report, invoice of funeral expenses, statements from health care providers or explanations of benefits from insurance indicating applicant’s out-of-pocket medical expenses; the documentation must substantiate the amount of financial assistance being requested. Documentation must be on letterhead or statement of owned party. Email supporting documentation to Emergency@encompasscares.org
Please provide a narrative for the following:
Check one of the following:
Mailing address:
Encompass CaresAttn: Emergency Relief Fund6688 N Central Expy. Ste 1300Dallas, TX 75206
**Encompass Cares shall not obtain any information that would constitute "protected health information," as such term is defined in 45 CFR 160.103, from Encompass Health, Homecare Homebase, or their wholly owned subsidiary or affiliate or any group health plan sponsored by one of the aforementioned parties.