NEHA Emergency Financial Assistance


Wicked Strong. Together.


The NEHA Emergency Assistance Fund is available to help families and individuals in the bleeding disorders community experiencing a financial hardship. Individual donations, grants, and the funds raised at our annual Unite for Bleeding Disorders Walk and other events, support this Fund. Each year, more than $30,000 is provided to New England families experiencing a financial hardship by helping them with non-medical expenses like utility bills, transportation, rent, and food.

The fund is not meant to be used to remedy chronic financial problems, nor does it apply to insurance or mortgage payments, or drugs and factor supplies. This program does not cover insurance premiums, deductible, co-payments, or co-insurance. Funding requests may be considered once a year for a maximum of $500 and must be referred by a healthcare provider.


About the Process

To assist in the review and validation of applications for aid, we only accept requests from providers at Hemophilia Treatment Centers (HTC) or at other institutions where you receive care to treat your bleeding disorder. Healthcare providers typically know the candidates, understand their current financial state, and are better suited to determine the severity of the need for emergency funds.

Follow-up calls may be necessary when information is missing or to discuss the specific case when the need is unclear. Individual requests without HTC support may also be considered.

Eligibility Requirements

  • The applicant has a bleeding disorder and/or lives in the same household of the person with a bleeding disorder.
  • The applicant lives in one of the six New England states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, or Vermont.
  • The applicant has not applied within the last 365 days.
  • The applicant is experiencing a hardship directly resulting from or directly affecting the bleeding disorder.
  • The request is related to food, housing, utilities, or transportation.

How To Start An Application 

  • The applicant identifies the need (i.e. electric bill, mortgage, food, etc) and collects the appropriate documentation.
  • The applicant contacts their healthcare provider team.
  • The applicant asks their healthcare provider to fill out the below form on this page.
  • Once an application is submitted by a healthcare provider, a decision is made within 5 days.

Application for Emergency Financial Assistance

This form should only be completed by a healthcare professional. If you are a patient seeking financial assistance, please ask your nurse, doctor or social worker to submit a request on your behalf.

  • Please use both the first and last names of both parents. If not applicable, please leave this field blank.
  • This should be the name of the business that the check will be sent to.
  • Drop files here or
    Accepted file types: jpg, gif, doc, docx, png, pdf, Max. file size: 24 MB, Max. files: 5.
      In order to process your request, please upload documents to support your claim for assistance.