The Pediatric Amino Acid Formula Emergency Assistance Fund Online Patient Portal

Welcome to the Pediatric Amino Acid Formula Emergency Assistance Fund online application portal. The application process is simple and requires a one-time registration process.


Getting Started

If you are a first-time applicant, please register by selecting Patient Registration below and fill in the required information. You will receive a confirmation email in your inbox that will ask you to confirm your registration by creating a password within 2 hours.

Patient Registration

Once you create your password, you can log in and start an application using the "Apply Now" link below.

Apply Now

Already Registered?

If you have already registered and/or submitted an application, you can log in using the "Check your application status" link below

Check Your Application Status

The following information is required when applying:
  • Patient or Guardian name, date of birth, mailing address, phone number, email address, marital status, ethnicity, veteran status, employment status, and social security or Alien Identification Number.
  • Patient's physician information (name, address, name of practice, office phone, and fax number)
Patients who need additional assistance with, or have additional questions about applying for a Financial Aid Fund award may call us at 855-949-3915, Monday through Friday between the hours of 8:30 a.m. and 5 p.m. EST. We look forward to assisting you!
The Pediatric Amino Acid Formula Emergency Assistance Fund is a program of Patient Advocate Foundation and is made possible through the generous support of Abbott. The program reviews and processes applications in the order in which they are received. To learn more about the program, please visit www.patientadvocate.org/FormulaEmergencyAssistanceFund
Application system requirements include:
  • Internet Explorer 8 or higher
  • Google Chrome 30.0.15 or higher
  • Firefox 4.0
  • Adobe Reader 9 or higher version
  • File size uploads are limited to 2MB

Please note: Cookies must be enabled. Cookies are usually already enabled, but refer to your browser's help documents for instruction on how to enable cookies if they are disabled. If cookies are not enabled, you will not be able to log in, and will see the log-in page repeatedly. Older versions of these browsers, or browsers not listed here, may not work. Please use one of the browsers listed above for full functionality. Each one is free, widely available, and often pre-installed on many computers.



The Pediatric Amino Acid Formula Emergency Assistance Fund is supported by Abbott