Get Lyme Test Access Program (lyme-tap) 2014-2025
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How to fill out the Lyme Test Access Program (Lyme-TAP) online
The Lyme Test Access Program (Lyme-TAP) is designed to assist patients facing financial hardship by reimbursing them for eligible Lyme-related lab tests. This guide provides comprehensive steps on how to fill out the Lyme-TAP application online, ensuring you understand each component to facilitate a smooth application process.
Follow the steps to complete your application effectively.
- Click ‘Get Form’ button to access the Lyme-TAP application and open it in your chosen editor.
- Begin by entering your personal information in the 'Your Information' section. This includes your name, address, phone number, and email address.
- Provide details about your healthcare provider. Include their name, address, phone number, and email, ensuring that the provider is the one who ordered your test.
- If applicable, include information for child dependents. Enter their name, address, age, and contact details.
- In the 'Diagnostic Test Information' section, specify the tests performed and their costs. Indicate if you have been tested for Lyme disease before.
- Complete the 'Laboratory Information' section by providing the name and address of the laboratory where your tests were conducted.
- In the 'Statement of Financial Need' section, select your basis for financial need, whether low income or other circumstances, and attach required documentation like the first page of your 1040 Federal tax return and receipts from laboratory tests.
- Acknowledge that you do not have insurance to cover the tests by checking the appropriate box.
- Read the application instructions thoroughly, including the disclaimer, and then certify that the information you have provided is accurate by signing and dating the application.
- Lastly, submit your completed application form along with all required documents via fax, email, or standard mail as indicated.
Take the next step towards accessing financial assistance by completing the Lyme Test Access Program application online.
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Yes, you can order your own Lyme disease test through the Lyme Test Access Program (Lyme-TAP). This program allows you to request a test directly, streamlining the process without needing a traditional doctor's visit. By using Lyme-TAP, you can take control of your healthcare, and you will receive guidance on next steps after the test. This accessibility empowers you to stay proactive about your health.
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