It is a humbling experience asking for help. No one likes to admit that for once, you cannot stand on your own two feet and help yourself. Cancer is a debilitating disease that knows no boundaries of income or ability.
We understand the need and want to make our application as simple and easy as possible. All applications are treated with confidentiality and compassion.
If you are a resident of Rockingham County and have been diagnosed with cancer, please fill out the short form below. You may email the form, mail it in or call and we will come out and visit to pick it up. Whatever is most convenient for you. Our volunteer board of directors reviews each form anonymously, and someone from the fund will get back with you with a response within a few short days.
Please provide as much detail as possible when completing the application form. While we typically help patients with utility, grocery, or pharmacy bills, we are happy to consider unique requests for financial assistance. All reasonable requests will be considered.
Please click here to download the application form.