1. The BSTTW Medical Application
must be filled out, signed and notorized. You can download the application at BSTTW Medical Application Download.
In order to view the BSTTW Medical Application, you must have Acrobate Reader installed
in your computer. If you do not please download it before trying to read the BSTTW Medical Application.
The Acrobate Reader is free of charge. You can download the program by clicking the Adobe Icon
2. You must write a letter to BSTTW
expressing your burn injury, when it was, what medical treatment your received, what is happening in your life today,
do you work (if yes, were and how much your income is), if married how much your husbands income is, do you have medical insurance and
what medical treatment you are requesting.
3. A list of the names of all doctors who offered
you treatment due to the burn injury.
4. A letter from your primary doctor and specialist(s)
stating the diagnosis and what medical treatment is needed at this time.
5. If you and/or your husband are employed you
A. The name, address, contact individual and
telephone number of the employers.
B. The monthly and yearly income of each
individual and combined totals.
C. The Social Security Number of you, your
husband and children.
6. If you are on medications, a list of all medications
you are currently taking.
7. BSTTW will need the following
pictures: before the burn injury, most recent pictures after the burn injury, pictures during recovery and current pictures of you. This
will help BSTTW and the doctors have a better understanding of your needs.
You must mail all of the above to BSTTW. Our mailing
Burn Survivors Throughout The World, Inc.
16103 Lone Star Ranch Drive #102