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> Cooling program Application

MSF Cooling Program

More often than not, heat and MS don’t mix. As the body temperature rises, weakness, fatigue, visual disturbances, and other symptoms can become aggravated and temporarily worsen. While heat does not actually make MS worse, it does alter the passage of nerve impulses, causing a feeling of weakness, especially in the limbs.

But keeping the body cool can help a person with MS to reclaim those sun-splashed days of summer and the countless activities associated with the season, like gardening, fishing, walking, biking, family outings, barbeques, and baseball games. The MSF Cooling Program offers a variety of items, free of charge, including:

  • Cooling vests
  • Neckties
  • Wristbands
  • Bandanas
  • Work collars
  • Skull-pads
  • Baseball hats

The Application Process

Our program cycle begins on February 1st and continues through June 1st. Applications can be submitted online at www.msfocus.org or via postal mail. All applications are confidential and will be reviewed by the grant committee. For more information on the MSF Cooling Program, or to access these services, call: (888) MSFOCUS (673-6287).

Applications are confidential and will be reviewed by the grant committee.

ALL FIELDS ARE REQUIRED
Name:
E-Mail:
Address:
City:
State:
Zip:
County:
Day Phone:
Alternate Phone:
Physician's Name:
Physician's Phone:
Date Diagnosed:
Monthly Gross Income:
Monthly Expenses:
Disposable Income:
Current Major Symptoms:

Do you or your spouse have medical insurance?:
  Choose one option only:
Full Vest : Choose Size/Color
Sports Package: (includes half vest, hat, necktie, wristbands) Choose Size/Color

Accessory Package:

Hat Size/Color:

(package includes hat, necktie, wristbands)

By checking this box, you are stating that the information above is true, and that you release and hold the Multiple Sclerosis Foundation, Inc. harmless from, against, and in respect of all claims, injuries, actions, demands, suits, losses, liability, or other damages that may incur as a result of accepting goods or services.

 

 

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