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Family Assistance Fund Application

The Family House asks for $40/room/night. If you’d like to request a reduced rate, please fill out this application.

Before proceeding with this application:

  • Please request a referral form from the medical center providing treatment before submitting this application.
  • If you are a patient staying at the Family House for outpatient treatment, do you have Medicaid? If yes, we may be able to bill your stay to your Medicaid Insurance. Please call 336-793-2822 to proceed.
Family Assistance Fund Application
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SECU Family House Winston-Salem
1970 Baldwin Lane
Winston-Salem, NC 27103
info@familyhousews.org
336-793-2822
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