{Name}
{Address}
{Phone #}
{Date}
Dear {friends and colleagues}:
As you may have heard, I was diagnosed in {month and year} with {condition/disease}. With the help of my family, friends, and colleagues, I have been throwing all I have at beating this thing. And it looks like I'm winning. The latest reports indicate {improvement/prognosis}.
What's losing, however, is our bank account. It's been quite a stretch getting by on barely one income, as short-term disability benefits don't come close to matching my salary. Now we are faced with the financially insurmountable: losing our health insurance.
Our whole family's insurance had been covered through my work plan at {amount} per month. Now, my sick leave has run out. If I don't go back to work full-time by {date}, which my doctors say is physically impossible, we will lose our insurance, and our COBRA premiums will exceed {amount} per month.
I am reaching out now to anyone who works for {school district/company/entity} and is able to donate their sick time to me via the catastrophic leave program "pool." I need a total of 90 hours by {date} in order to keep our coverage.
Thanks so much to those of you who have {brought meals/watched kids/provided transportation}. We would truly be in dire straits without you. Please consider spreading the word among your friends who work for {school district/company/entity}. I've attached a copy of the application to donate sick leave time. Donations can be in full- or half-day increments.
With love,
{Sender Name}
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Index of Hardship Letter Examples