- For your enquiry on applying for medical equipment, please visit our website at https://www.lfm.org.my/#funding, download, fill the forms and email to us the completed forms. The welfare form has to be filled and submitted by patients directly via LFM’s website. All other forms below need to be submitted by the Doctor-in-charge to the Lung Foundation’s email address (lungfoundation@gmail.com).
The forms/reports are:- Medical Report (prepared/verified by Respiratory Consultant)
- Clinical Form (prepared/verified by Respiratory Consultant)
- Welfare Form (filled by patient at LFM website)
- Donation Agreement Form (filled by patient and Dr in charge)
- Supporting documents, a copy of:
- Patient IC/birth cert,
- Parent IC (for paeds patient)
- Patient/guardian payslip,
- Utilities bill (electricity/water)
- Please be advised that applications for medical equipment typically entail a review period of approximately two weeks to obtain approval from the LFM Board of Trustees. This does not include the time for equipment procurement and delivery. It is also important to note that approval is not automatically guaranteed.
Kindly fill up the form attached and submit via email or fax it back to us.
