Elsie and Pansy Allen Memorial Fund

Purpose: Provide financial assistance to residents experiencing hardship due to illness or medical conditions

Geographic Scope: Davie County and Southeast Yadkin County, NC

Eligible Uses:

• Medical bills and out-of-pocket medical costs not covered by insurance
• Support for residents experiencing medical hardship

Priority Focus Areas:

• Cancer
• Chronic disease
• Other long-term illnesses

Application Review: Applications are reviewed monthly; applicants will be notified once decisions are made

Contact:

• Phone: 336-753-6903
• Email: info@daviefoundation.org
• Address: P.O. Box 546, Mocksville, NC 27028
• Location: 107 N. Salisbury St, Mocksville, NC 27028

Application Process

Required Materials:

1. Personal information (name, email, phone, address)
2. Description of medical condition
3. Validating information from doctor
4. Copies of medical bills
5. Financial documentation including:
   • Monthly income from all sources
   • Monthly expenses (housing, phone, utilities, food, necessities, medical expenses, other)
   • Out-of-pocket costs not covered by insurance
   • Amount already paid
   • Amount requested
6. Documentation of payment plan discussed with care provider
7. Signature and consent to terms

Timeline: Applications reviewed monthly with notification once decisions are made

Contact for Assistance: 336-753-6903 or email info@daviefoundation.org