Lyme-TAP Application

The Lyme Test Access Program (Lyme-TAP) is a nationwide assistance program for initial Lyme-related lab tests to eligible patients facing true financial hardship based on household income and insurance status.

Lyme-TAP program funds are temporarily depleted. We are currently not accepting applications. Please check the website regularly for reopening when funds are available again.

Download the application by clicking on the button below and fill out the form completely. This is an interactive form and you can type directly into the fields supplied. Once you are finished, simply print out the form.

Submit the following to the submission fax line: 707-924-3013

  1. Your completed application form – Please either fill out the form by typing directly into the fields. If you are filling out the form by hand, Please print clearly. (Submit separate application forms for additional family members) PLEASE INCLUDE AN EMAIL ADDRESS ON THE APPLICATION. Applications with no email address may take longer to process.
  2. Pages 1 and 2 and Schedule 1 of your 2018 1040 Federal tax return or page 1 of 2017 1040.
  3. The laboratory test receipt(s). If opting for a prepayment to the lab, submit a copy of your lab requisition form with pricing, signed by your healthcare provider. (Payments of grant funds may take several weeks).

Once you have faxed this information, please follow up with an email to the program administrator [] indicating that you have sent in your fax.

*Prepayments may take longer to process than reimbursements and may not be possible with all laboratories.

Applications may also be submitted by mail to the address shown below or by email (in pdf format) to Please note that mailed applications may take longer to process.

Lyme Test Access Program (Lyme-TAP)

P.O. Box 2238, McKinleyville, CA 95519

If approved, you may be reimbursed for up to 75% of the list price that the labs publish for testing costs for lyme, co-infections and CD57 from a qualified, CLIA/Medicare-approved lab of your choice. Funds are limited & are available on a first-come, first-served basis. Children under 18 years of age are given priority.

Please refer to Lyme-TAP Tips for any questions that you may have regarding the application process.