American Association of Professional Ringside Physicians

Medical Assistance Program

The goal of the AAPRP Medical Assistance Program is to deliver discounted (or free) health care to those boxers and their families who don’t have health insurance or means to afford to pay for their health care.

It is our hope that we can form an AAPRP Medical Assistance Referral Panel across the country in order to enable these individuals a mechanism to seek and receive this medical care.

If you are interested in participating, please complete this form.  We will then utilize the information as a referral base for those boxers contacting the AAPRP in search of medical care.  No information will be shared or used in any other fashion except for this purpose.  Additionally, the specifics of the discount (or free) medical care is the sole discretion of the participating physician.  You are in no way obligated to see any individuals referred to you.

This program is another example of how we can help care for these athletes and insure that their health and safety is preserved.

I appreciate your assistance and cooperation with this program.

Thank You,

Dr. Michael Schwartz

____ Yes, I would like to participate in this medical assistance program

____ No, I cannot participate at this time, but keep me updated

Name         ___________________________________________________

Address    ___________________________________________________

City            ___________________      State          ________  Zip    _________

Phone       ___________________      Fax   _______________________

Specialty  ___________________      Sub-specialty    ______________

Email         __________________________________________________    

Please return via fax: 203-662-8906 or mail to:

AAPRP

40 Heights Road

Suite 201

Darien, CT 06820