To request financial assistance from the Tri-State Multiple Sclerosis Association, simply complete one of the applications listed below in the format you can use. We can only provide financial assistance to individuals diagnosed with multiple sclerosis that live in the tri-state area.  To see if you qualify please contact us prior to filling out the financial assistance forms.

PDF Format:

Word Format:

After completing any of the above applications, fax  to 812-423-5650 or e-mail to or mail to:

971 C. Kenmore Drive
Evansville, IN, 47714 is the sole owner of and the only organization that uses the information collected on this site. We will not sell, share, or rent this information to others under any circumstances.

Help is only a phone call away…The Tri-State MS Association!
423-5943 or toll-free 1-866-514-4312

We are blessed in this tri-state area to have a local association providing services to people living with M.S. and their family members. We want you to take advantage of those services and to help us spread the word to others living with or affected by this disease.

Some of the services we provide include:
• Seven local support groups
• M.S. Mentors-people living with M.S. who are willing to meet with or talk by phone with newly diagnosed individuals
• Educational programs
• Lending library
• Referrals to doctors, home care agencies, rehabilitation providers, vocational counselors, pharmaceutical companies, and more
• Social events-it is important to build relationships with other people who can truly understand what it means to live with M.S.
• Financial assistance
• Carepartner services and family programs

Susan Reynolds, nurse educator for the Tri-State M.S. Association, welcomes appointments at the office or she is glad to talk to you by phone. She can help address questions regarding M.S. medications, side effects, symptom management, or the disease in general. She can also advise you regarding obstacles you encounter because of M.S. She herself has been living with the disease for a number of years.

Offering support, care, and hope…right here at home! Call us today!