If you or someone you know is having to make difficult decisions regarding payment to continue cancer treatment, please download our cover letter and application here:
If you are unable to download the application, call us today and we will mail you the application and cover letter.
Eligibility for assistance includes:
- A woman who has been diagnosed with breast, cervical, endometrial, ovarian, uterine, vaginal, or vulvar cancer
- Living in or obtaining treatment in one of the 22 counties of Western North Carolina
- Under-insured, uninsured or need financial assistance
- Complete and submit our application and provide supporting documents
Once the application, your most recent pathology report, and copies of your bills are submitted, we will call you and explain our approval process. It may take 2-3 weeks for approval.