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

In order to be eligible for financial assistance, you must:

  1. Be a Massachusetts resident
  2. Have a cancer diagnosis
  3. Have a household income less than 400% of the federal poverty level

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.

STEPS FOR APPLYING

  1. Complete our financial assistance application
  2. Mail your completed application and all supporting documents to:

    Cancer1Source Assistance Programs
    50 Whittemore Street
    Gloucester, MA 01930

    OR

    FAX your completed application and all supporting documents to

    888-246-6527

If you are eligible to apply, you must also provide support documentation.

  • A signed  letter from your healthcare provider on official letterhead verifying your cancer diagnosis
  • A signed letter from you verifying that your meet income guidelines and that you are  a Massachusetts resident

Programs we provide support for:

  • Cancer Genetic and Genomic Testing and Counseling
  • Medication Assistance
  • Transportation Assistance
  • Meals and Food Assistance
  • Lymphedema Garment Assistance
  • Wig/Hairpiece Assistance

Please be sure to answer ALL questions completely, sign, and submit the required documentation.

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 and all supporting documents, we will review your application and make a determination within 7 days. You will be notified by email.

If you are approved for a program, you will receive your appropriate gift card in the mail within 14 days after approval.

Online Application
Download Application
  1. Complete online or print the application
  2. Complete all information
  3. Sign the application
  4. E-mail or Fax the application with supporting documents