Applications

You can apply to the Program by either using the online system or by downloading the form below that best describes what you did on 9/11. You should only apply once.

 

Eligibility Applications

WTC Health Program Responder Eligibility Application – FDNY

WTC Health Program Responder Eligibility Application – General Responder

WTC Health Program Responder Eligibility Application – NYC Survivor

WTC Health Program Eligibility Application –  Pentagon & Shanksville, PA

Supporting Documentation

For more information on how to enroll – click here

 

What You Need to Send

If you used the online system:

  • You may submit your required supporting documentation through the website or send it through the mail or fax.

If you downloaded the forms listed above:

  • You need to send the signed application form and copies of your supporting documents (or your report on why you couldn’t get the documents).

Where To Send Documents

  • Mail to:
    WTC Health Program
    P.O. Box 7000
    Rensselaer, NY 12144
  • Or you may send your application and copies of your documents by fax to: 1-877-646-5308