Aid Request Form

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Medical Aid Request Form

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If you need help from RESCU, print and fill out our Medical Aid Request Form.

Then mail it, along with copies of all pertinent medical bills to:

RESCU Foundation, Inc.
2206 N Main St. #223
Wheaton, IL 60187
Or fax to: 888-299-9513

*Send questions related to filling out or submitting the aid request form, .