This form is to be used to make a loan request for financial assistance for medical reasons. All requests will be reviewed on an individual basis within 24 hours of receipt and the decision will be forwarded via email to the individual making the request. Any payments will be made within 7 days of the decision via bank transfer, Paypal or other financial institutions. In the event that the request is successful, the beneficiary will be required to repay the loan amount provided via installments deducted from their following monthly invoice submissions. Please note that all requests will be reviewed on a case-by-case basis and that we may be unable to approve the requested amount in full.