| |
Financial Assistance for Patients
Qualifications (effective October 1, 2009, through September 30, 2010)
- Grant applicants must have a cancer diagnosis and be currently receiving medical treatment for cancer.
- Grant applicants must be a Colorado resident or receiving treatment in Colorado.
- Grant applicants must be 18 or older.
- Annual household income cannot exceed 60 percent of the Colorado median income level. See chart for income levels for 2009/2010
Household Size |
60% of Colorado Median Income |
1
2
3
4
5
6
|
$23,774
$31,090
$38,405
$45,720
$53,035
$60,350
|
- All applications must be accompanied by a completed Grant Request Verification Form.
- Applications will not be considered complete without a verification of a cancer diagnosis and current treatment from a healthcare professional (physician, nurse, social worker, or patient navigator).
- You may call or write to request a Financial Assistance Application.
- Only completed applications will be accepted.
- Applications that are incomplete will be returned to patient and must be completed before resubmission.
- Applications may be completed by patient with help from any healthcare representative.
- Applications must be received no later than 5:00 p.m. on the 1st and 15th of each month.
- Applications received after the deadline will be reviewed the following month.
Mail completed applications and supporting documents to:
Rocky Mountain Cancer Centers Foundation
1161 S. Vivian Street
Lakewood, CO 80228
Applications may also be faxed to us at: 303-984-4344
Click the above link to open it or right click to download the file. The application is a PDF. If you do not have Adobe Acrobat Reader, please click on the icon below to download the free software.
Adobe Acrobat Reader download icon: http://www.adobe.com/products/acrobat/readstep2.html
- Applications are reviewed by the RMCC Foundation staff. Incomplete applications will not be considered and will be returned to the referring health care professional to be completed.
- If an applicant is approved for assistance, the referring professional will be notified by phone or e-mail regarding the amount of the assistance.
- Financial assistance checks are made payable to the vendor and sent to the applicant for mailing to the vendor.
- If applicable, a voucher or coupons for food will be sent directly to the patient.
The RMCC Foundation's financial assistance typically pays for the most basic of needs: food, housing, utilities, transportation, and medicines. This support helps reduce the stress of maintaining daily routines during treatment and contributes to retaining dignity and quality of life.
|
|

Rocky Mountain Cancer Centers Foundation
1161 S. Vivian St.
Lakewood, CO 80228
T: 303 930-7822
F: 303-984-4344
The Rocky Mountain Cancer Centers Foundation benefits Colorado cancer patients and families. Thank you to the Gannett Foundation for supporting RMCCF
with a grant for our Financial Assistance program.
www.9news.com |
|
|
 |