Get The Help You Need
Apply For Assistance
Application Requirements
- You must be in active treatment (i.e. Chemotherapy, Radiation Therapy, Immunotherapy, or have had cancer-related surgery within the last 30 days) at an Arizona facility to be eligible for assistance.
- Applicants can apply for a maximum award of $500 per calendar year.
- You must upload a certification from your oncology office to confirm your active treatment status. This form must be signed by your provider. Please download the form below.
Important information
- Completing an application does not guarantee funds. Funds are dispersed based on need and funds available regardless of treating physician or where treatment is received.
- The information provided on your application will be kept in the strictest confidence and used only for the purpose of determining eligibility.