In order we could help you, you need the following documents:
1. A story about yourself (or child), the history of the disease, the severity of the condition, the amount of treatment cost per 1 month.
2. Application to the Foundation (according to our example)
3. Agreement with the Foundation.
4. Photocopy of the passport.
5. Photocopy of the identification number
6. Photocopy of birth certificate of a child (if child needs help) + photocopy of a passport and ID number of a parent.
7. Photocopy of certificate of disability.
8. A medical extract, a medical discharge from the hospital confirming the diagnosis.
9. Power of Attorney (If the patient is hospitalized and needs an agent that represents the interests of the patient with her nameplate, ID card number and passport data, the identification number of the trustee. A power of attorney must be sealed by the chief physician, the institution in which the patient is treated.
10. Certificate of residence and family members
11. Photo of you (or your child) before and during treatment.
AGREEMENT (for child), AGREEMENT (for adult), APPLICATION (for child), APPLICATION (for adult) can be found at: https://drive.google.com/drive/folders/1aAU-74lYxu9DxnfARWEXWHvI24SzYVCD?usp=sharing
All copies must have a remark: Copy is correct, according to original. Date, signed.
Agreement, application and copies of documents should be sent by registered mail to the address: Lviv, Hlyboka str. 12 (office) or by Nova Poshta#15, Lviv, Heroiv UPA 6 (tel. 097 693 87 96, Andrii Hulei).
The Fund has a personal checking account and provides a daily report on the flow of funds.
The Foundation does not provide financial assistance, assistance is provided only by providing medicines and helping in diagnostics charge or any surgical intervention.
Our volunteers are working on a voluntary basis.
In case of death of the child, the funds collected on his or her treatment remains on the account at the discretion of the fund staff is transferred to another sick child.
IF THE WARD IS AGAINST THE DISSEMINATION OF THE INFORMATION:
If, due to different circumstances, the ward is against of disseminating information about himself, we understand that. In such cases, assistance is provided from the non-addressed funds of the Foundationnd. However, this greatly reduces the ability to help you fully.
TO GET A 50% DISCOUNT on Sildenafil drugs (Revatsio) which according to the law (Decree of Cabinet of Ministers since 25.03.2009 р. №333) the state should provide you, as invalid of the 2-nd and 1-st group, you need the following documents:
1. An application ( 2 copies) addressed to The City Health Department. One is handed in to the administration, another one you leave for yourself on which you indicate the number of input applications that you gave. The sample of the application is on our website (an extract of the disease with the prescription of sildenafil and revatsio, photocopy of passport, identification card, MSEK).
2. An application (2 copies) to the Regional Health Department. One is hand in to the administration, another one you leave for yourself on which you indicate the number of input applications that you gave. Extracts of the disease with the prescription of sildenafil and revatsio, photocopy of passport, identification card, MSEC, the response from the municipal administration). The sample of the application is on our website
3. Admission to the mayor of your city where you should show show the rejections (if you have ones), and tell the essence of the problem in the application again in 2 copies and copies rejected applications from the city and regional administration.
4. Involve municipal aid foundation, which according to its statute can help you and to attract the media as much as possible.
5. To send the copies of the rejected applications and the resolution of the mayor of your city to the Ministry of Health together with the application.
List of documents required for consideration by the Ministry of Health of Ukraine on referral for treatment abroad:
1. Application from a citizen that needs treatment abroad (or his legal representative) using a form approved by the MoH (https://drive.google.com/drive/folders/1XpVpp3JDx0oJFVnN5vDikKIPzBmHLlAq?usp=sharing))
2. An extract from the medical card of an outpatient (inpatient) patient in the form approved by the Ministry of Health.
3. Letter of dispatch from the Ministry of Health of the Autonomous Republic of Crimea, structural divisions for health care of regional, Kyiv and Sevastopol city state administrations, respective ministries and other central executive bodies in the form approved by the Ministry of Health.
4. Documents confirming the registration of the place of residence of the citizen and the certificate of the composition of the family members or persons registered in the residential premises, at home.
5. Information from the State Register of Individuals - Payers of Taxes on Amounts of Received Income and Certificate of Income of a Citizen and Members of His Family;
6. Consent to the processing of personal data in accordance with the law.
7. Obligation of the citizen or his legal representative to submit (no later than one month after the return of the patient to the territory of Ukraine after treatment abroad at the direction of the Commission of the Ministry of Health) written information (report) on the volumes of the performed treatment and the amount of funds spent for the treatment of a patient provided by a foreign healthcare institution, or in case the patient is unable to obtain information from the said institution about the amount of such funds - a written refusal provided by the institution.