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 2008.
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
|
Referrals
- 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).
Grant Application and Grant Request Verification Forms
- 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.
- All payments are made directly to the provider or vendor of services.
- Applications may be completed by patient with help from any healthcare representative.
Cover Letter and Application
- Applications must be received no later than 5:00 p.m. on the 5th of each month to be considered that 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
Application Download (PDF 63k)
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
How we process your application
- Applications are reviewed for completeness by the RMCC Foundation staff. Incomplete applications will not be considered and will be returned to the referring health care professional to be completed.
- Completed applications are reviewed by the Financial Assistance Committee to decide if the patient qualifies for funding and how much is available.
- 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.
What we fund
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.
This site is donated and maintained by CMMart, LLC
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