Latvian Relief Fund of America

LRFA is a professionally managed, non-profit, mutual assistance organization, designed to provide our members with affordable health care plans and financial assistance in emergencies. We support other Latvian-American organizations and education in the U.S. and abroad.
Membership Benefit Plans About Us Forms Contact Us
Information Request Form
Change of Address
Benefit Plan Enrollment
Travel Plan Enrollment
Benefit Claims
Make a Payment

Benefit Plan Enrollment

The forms in this section are Adobe Acrobat Files. These are downloadable, printable publications containing full text and graphics. You will need to have the Adobe Reader installed to use these forms. If you do not have it, you can download it for free from  Adobe.

Please select a Plan below to view and print the appropriate Enrollment form. To enroll in a plan, you must first be a member of LRFA (or apply at the same time). If you are not currently a member of LRFA, please see our Membership section.

© 2017 LRFA   -   P.O. Box 8857, Elkins Park, PA 19027-0857   -   info @