Rainbow Health's Every Penny Counts™ Emergency Financial Assistance offers limited emergency financial aid to individuals and families living with HIV. This assistance can help pay utility bills, rent, mortgages, medical costs, and select other costs. Each program has slightly different eligibility guidelines to qualify, and any funds will be paid directly to vendors as opposed to individuals. To apply for emergency financial assistance, please check the documentation below to see if you qualify and then download and return the application materials.
In order to serve our clients, we are required to collect some information to determine eligibility. If you are interested in Every Penny Counts Emergency Financial Assistance, please complete and return the forms below. You can also request an application packet by calling 612–331–7733 or 800–565–9028.
+ open this form online and type your responses; when complete save the file to your desktop and email it or print it out and fax or mail it.
# This form must be printed, filled out and faxed or mailed.
Please return these forms in person, by mail, or by fax to:
2577 Territorial Road
St. Paul, MN 55114