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Avila’s Cancer Fund

Financial Assistance Guidelines

Si Habla Espanol 

 

1.Must be  verified by a social worker or physicians office  signature is required on application.

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, DL or verification of identity please call 559-374-8613 for more information

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 40 miles distance from the treatment facility this approved on a case by case basis.

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.

8. Question regarding our services email [email protected]





Application must be signed by patient, and authorized representative.

email to : [email protected]

Media Release Form

Application

Application (Spanish)