Application

As a nonprofit organization that relies solely on donations and grants to fund our programs, funding may fluctuate, and our programs may have to go on hold. If we currently do not have funding to assist you, our team will make every effort to refer you to other financial assistance resources.

 

Eligibility for all Cancer1Source programs

 

To be eligible for financial assistance:

  1. You must be a Massachusetts resident OR actively being treated/referred by a Massachusetts Cancer Center Treatment facility.
  2. You have a cancer diagnosis
  3. Don’t have cancer but are seeking genetic testing and or counseling and require financial assistance; not otherwise provided (most genetic testing companies have patient assistance programs). We can especially help with co-pays.
  4. Are having financial hardships due to a cancer diagnosis

Cancer1Source provides financial assistance of up to $150.00/per person/per year. You may apply for more than one program; however, the maximum assistance per person is $150.00/per person/per year.

Programs offered most frequently:

  1. Cancer Genetic and Genomic Testing and Counseling
  2. Medication Assistance
  3. Transportation Assistance
  4. Food/Grocery Assistance
  5. Lymphedema, and other Garment Assistance (i.e., post-mastectomy bras, garments for those with PORTS to allow ease of access etc.)
  6. Wig/Hairpiece Assistance
  7. Utility
  8. Lodging/Hotel
  9. Medical billing
Online Application

* HIPAA (Health Insurance Portability and Accountability Act (HIPAA) of 1996 Compliance Statement:

* Cancer1Source is committed to protecting the privacy and security of your health information. We comply with all applicable requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the HITECH Act. Our organization has implemented comprehensive technical, physical, and administrative safeguards to protect Protected Health Information (PHI). Our staff receives regular training to ensure compliance with HIPAA regulations.

QR Code to Apply for Cancer1Source

Use the QR code above for ease of access and completion.

  1. Complete online application.
  2. Ensure all answers to questions are completed.
  3. Press submit application at the bottom of the form.
  4. Application can be downloaded and scanned: sending completed application to [email protected]
  5. Sign the application after confirming you understand and have agreed to the HIPAA compliance statement.
  6. Questions can be directed to [email protected]

Incomplete or unreadable applications will be returned. You must re-submit your application within 2 weeks to be considered for program assistance. If you re-submit your application longer than 2 weeks from rejection, your application will not be eligible for consideration.

Application Review Process

Once we receive your completed application, we will review it and make a decision within 7 days. You will be notified by your Cancer Center team in person or by email.

If you are approved for a program, you will receive your appropriate gift card in the mail within 1-14 days after approval. Some clients may receive funding directly from your Social Worker, Case Manager, or Nurse Navigator.