WE'RE HERE TO HELP.

Thank you for your interest in East Texas Cancer Alliance of Hope (ETxCAH) Financial Assistance Program. ETxCAH is a non-profit organization designed to assist with the financial burden many individuals are faced with have been given a cancer diagnosis. 

 

Below is the ETxCAH application for assistance. Please note that all applications must be submitted to ETxCAH by a referring professional (i.e. your family doctor, oncologist, social worker, or other health care professional who is involved in your care). Please read the instructions very carefully and fill out the application completely. Also, please be sure to list all your current expenses and complete the income information. ETxCAH will use the provided information to gain a complete understanding of your financial situation. 

To apply, applicants must meet the following criteria to be considered for assistance

 

  1. Have a cancer diagnosis from a medical doctor, preferably your family doctor or oncologist

  2. Reside in East Texas as classified by Deep East Texas Council of Government: Angelina, Houston, Jasper, Nacogdoches, Newton, Sabine, San AugustineSan Jacinto, Polk, Shelby, Trinity or Tyler County

  3. Must be in active treatment or within a 3 month period of treatment. 

  4. If declining treatment, patient must be admitted to a local hospice organization

  5. Must have a household income less than or equal to 250% of the 2018 Federal Poverty Level (see chart to right)

 

Please note, incomplete applications or applications submitted by clients will not be reviewed which will delay any funds being released. Also, this application is not a guarantee for financial assistance. 

Please download the application below, fill it out and mail to 

East Texas Cancer Alliance of Hope

P.O. Box 151114

Lufkin, TX 75915

- or -

Apply online with the button below. A referring professional must also fill out the form below.

Thank you again for your interest in East Texas Cancer Alliance of Hope. If you have questions or concerns please give us a call at 936-899-7307 or email info@etxcancerallianceofhope.org

East Texas Cancer Alliance of Hope © 2018

 

Resources

Financial Assistance Application

Referring Professional Application

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