WORLD TRADE CENTER HEALTH PROGRAM

Apply to the Program

For FDNY Responders and General Responders to apply to the WTC Health Program, please down load and complete the appropriate form and either mail or fax it to the address below.

WTC Health Program
P.O. Box 7000
Rensselaer, NY 12144
Fax number: 1-877-646-5308

If you have questions about completing the forms or submitting them, please contact us at 1-888-WTC-HP4U (1-888-982-4748)

If you are unable or have problems downloading the form, you may also ask for a hard copy to be mailed to you. To request a hardcopy of the form, please call us at 1-888-WTC-HP4U (1-888-982-4748)

FDNY Responders

Eligibility Form for FDNY Responders

Solicitud de elegibilidad para el personal de respuesta del Departamento de Bomberos de Nueva York

A WTC Health Program FDNY Responder is a member of the Fire Department of New York City (whether fire or emergency personnel, active or retired) who participated at least one day in the rescue and recovery effort at any of the former World Trade Center sites.

General Responders

Eligibility Form for General Responders

Formulario de preseleccin de solicitantes (no pertenecientes al Departamento de bomberos de NY)

Program zdrowotny World Trade Center Podanie kwalifikacyjne dla ratowników (nie dotyczy pracowników FDNY)

A WTC Health Program General Responder is a worker or volunteer who provided Rescue, Recovery, Demolition, Debris Removal, and related support services in the aftermath of the September 11, 2001 attacks on the World Trade Center, but was not affiliated with the Fire Department of New York.

For NYC Survivors and Community Members

Eligibility Form for Survivors

Programa de atención médica del World Trade Center Solicitud de elegibilidad de sobreviviente

Program zdrowotny World Trade Center Podanie kwalifikacyjne dla osób ocalałych

Eligibility_Form_for_Survivors - Chinese

A World Trade Center (WTC) Health Program Survivor is a person who was present in the disaster area in the aftermath of the September 11, 2001, terrorist attacks on the World Trade Center as a result of their work, residence, or attendance at school, childcare, or adult daycare.

Information for 9/11 Pentagon and Shanksville Responders

Information for 9/11 Pentagon and Shanksville responders can be found at http://www.cdc.gov/niosh/topics/wtc/ps-responders.html.