Medical Assistance Request Letter

January 13, 2005

Ms. Liana R. Sabino
ADLS Institution
Sunrise Subd. Makati City

Dear Ms. Sabino:

I would like to request for medical assistance for purchasing my medications I need to treat my heart disease. The medicine was prescribed by my specialist, Dr. Jose R. Sampang on January 10, 2005.

I was referred to your association by my doctor because the medications I need to take for the rest of my life are too expensive for me to afford on my fixed retirement income. I appreciate your goals and mention to give assistance to people eligible by helping them pay their medications.

I have enclosed my application form and my medical records stating all the medicines required to continue my everyday activities. Also, I have enclosed my last three bank financial statements and see that the cost of my medicine cannot afford than my monthly income.

Thank you for accommodating my request letter. If you have any question regarding my application, please reach me at 0952316641 or email me at gnc@yahoo.com. I hope for your favorable reply soon.

Sincerely yours,

Alfredo D. Herrera