Assist M.E. mission is to help low income, uninsured patients in our community. Thank you for your interest in the Charlotte Mobility Assistance Program. We hope to help you in your time of need. Please fill out all information on the attached form. We may call you if you have not filled out all parts of the form or if we need to know more information about your needs. 

You can send the filled form to receptionist@assistmenc.com

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