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Avila’s Cancer Fund

Financial Assistance Guidelines

 

1.Must be in current treatment verified by a social worker or physician office with a medical information form.

2. Applications must be signed by the patient. All forms may be emailed if you wish to come in please contact Avila's Cancer Fund for an appointment. 

3. You must have valid California ID or Drivers License

4. All payments will be paid directly to the vendor such as PG&E, Utilities, Landlord or Mortgage Company, Co-Pays are made out to the facility or physician’s office. A copy of the bill must be submitted prior to payment. For lodging request a minimum of 75-mile distance from the treatment facility.

5. Avila’s’ Cancer Fund offers financial assistance, and food cards while funds are available.

6. You can apply for financial assistance every six months from your first application.

7. Please allow 5-10 days from receiving the application to be notified.




Application must be signed by patient, or authorized representative.

email to : [email protected]

Application

Medical Information Form must be filled out by physicians office or social worker emailed to: [email protected]

Medical Information Form