Contact Us

Apply Visit Give

Prospective Educators
Parents and Community
Donors and Press
Quick Links

Request for Assistance Form

Request for Assistance Form

Please submit this form to request free, confidential assistance applying for health insurance and SNAP or accessing other resources. A member of the Excel Academy Benefits Access Team will contact you.

Parent Name(s):
Email:
Today's Date:
Excel Student Name(s):
Excel Academy Campus:
Grade:
Phone:
Best time(s) to contact you:
What is your Excel student's health insurance?
- MassHealth Standard
- MassHealth Limited
- MassHealth Family Assistance
- Health Safety Net
- Harvard Pilgrim
- Children's Medical Security Plan
- Blue Cross Blue Shield
- No insurance
- Other
Where does your Excel student receive primary care?
- Pediatric Medical Care
- MGH Chelsea
- East Boston Neighborhood Health Center
- Boston Medical Center
- Harvard Vanguard
- North End Waterfront Health
- Children's Hospital
- Other
How can we assist you?
- Assistance applying for health insurance
- Assistance renewing health insurance
- Assistance applying for SNAP (food stamps)
- Questions related to immigration, citizenship status, or legal resources
- Other assistance
Comments?

Join our mailing list!

Give

Excel Academy East Boston
58 Moore Street
East Boston, MA 02128
P 617.874.4080
F 617.419.1122
Excel Academy Chelsea
180 2nd Street
Chelsea, MA 02150
P 617.336.9970
F 617.399.6867
Excel Academy Orient Heights
1150 Saratoga Street
East Boston, MA 02128
P 617.561.1371
F 617.674.3429
Excel Academy Charter High School
401 Bremen Street
East Boston, MA 02128
P 617.326.3574
F 617.674.3427

© Excel Academy Charter Schools. Privacy Policy.

Website Design and Development by Interthrive