Apply for Assistance

Please click the "PDF" button below, print off, fill out, SIGN and:

Email to hello@rockymountainbloodfund.org

*If you do not have access to email please ask your case manager or social work provider for assistance with submission.

PLEASE NOTE: As of September 1, 2021; we are limiting financial assistance to $500.00/applicant due to a great influx in financial assistance applicaitons this year. RMBCAF will reevaluate applicant funding in 2022 with hopes to increase back to $1000.00/applicant.