Qualifications for Patient Assistance Program

joey on my shoulderTo qualify for financial assistance a request must meet the following (3) criteria:

  • The patient must be a resident of Onondaga, Oneida, Herkimer, or Madison Counties in NYS or be receiving treatment in these counties.

  • The patient or guardian (if under 21) will need to complete a Financial Assistance/Consent Form, which will require the patient’s signature or guardian’s signature along with the treating oncologist OR radiologist signature-this ensures the proper use of foundation funds. A LMSW working with the oncologist or treatment center may sign the application as a health care provider for the patient.

  • The patient must be diagnosed with cancer, currently under going treatment - Chemo, Radiation, Targeted Therapy, Cancer Surgery - (not conditions resulting from cancer treatment) and the patient/family must be experiencing financial challenges resulting from illness related expenses.

Please feel free to contact the Foundation should you have questons about eligibility of the patient/family.

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