Client assistance
Client Assistance Form
Direct financial assistance for cancer patients and their families during treatment and recovery. All cancers, all ages, for Michigan residents. Start here, and we'll take it from there.
Assistance available
What we can help with.
All needs are subject to stipulations. Assistance is provided on a first come, first served, case-by-case basis, and as funds are available.
Prescriptions & Co-pays
Help covering prescription costs and co-pays during treatment.
Lodging
Help with stays near treatment centers when care is far from home.
Travel Costs
Fuel and travel to and from treatment, including out-of-state care.
Medical Insurance Premiums
Help keeping coverage in place while you are on leave from your employer.
Medical Equipment & Supplies
Purchase or rental of the equipment and supplies your care requires.
Medical Expenses
Assistance with additional medical costs related to your cancer care.
Grief & Emotional Support
Help locating grief and emotional support groups for you and your family.
Cancer Benefits
Planning a benefit for someone with cancer? We can help you make it a success.
How it works
Four steps from request to relief.
- 1
Complete the Client Assistance Form
Tell us about the client, the diagnosis, and the financial needs. It takes about 10 minutes online.
- 2
We follow up with a phone call
A short evaluation by phone, in most cases 15 to 20 minutes, Monday to Friday between 10 a.m. and 3 p.m.
- 3
Your physician confirms the diagnosis
We send a one-page Confirmation of Condition. Your physician writes out the diagnosis and returns it to us.
- 4
Funds are released
Once we receive the confirmation, we can release funds toward the approved needs.