Apply for Assistance

Both Financial and Transportation Assistance available

 The New York Cancer Foundation is a 501(c)(3) organization which offers financial assistance grants for non-medical expenses and transportation grants to qualifying patients who are undergoing treatment for a cancer diagnosis in New York State. The Foundation strives to relieve some of the financial burden patients face so they may focus on their treatment.

Do I Qualify?

• Applicants must be 18 years of age or older.

• Applicants must currently be undergoing cancer treatment.

• Applicants must be citizens of the United States.

• Applicants must be a resident of New York State.

• The annual gross income of household must be at or below 400% of the Federal Poverty Guidelines.The combined liquid assets of the applicant and their household, which include cash,checking and savings accounts, stocks, and similar financial resources, must not exceed $12,500.

2025 Poverty Guidelines for the 48 Contiguous States

Persons in Family – Poverty Guideline 400%

1 – $62,600
2 – $84,600
3 – $106,600
4 – $128,600
5 – $150,600
6 – $172,600
7 – $194,600
8 – $216,600

DOCUMENTATION CHECKLIST 

Required documents for applicant:

• Complete the application form, ensuring that page 5 is signed.

• Provide a copy of your Driver’s License or Non-Driver’s License.

• Submit the Patient Treatment Verification Form (page 4), duly completed and stamped by your Oncologist.

Documents Required for the Applicant and the Spouse or Significant Other:

• The most recent bank statements for all accounts held in your name (including savings, checking, stocks, credit unions, certificates of deposit, etc.). Please include all pages andthe last four digits of the account number.

• Documentation related to current income. (EX: 2 paystubs, Award/Budget/SSI Letter)

Examples of income documentation:

Please identify all applicable sources of income for both the applicant and the spouse or significant other, and attach the corresponding supporting documentation:

□ Salary

□ Public Assistance

□ Short-Term/Long-Term Disability

□ Alimony

□ SSI/SSDI

□ Unemployment

□Pension

HOW CAN I SEND MY APPLICATION?

Mail:

New York Cancer Foundation
20 Ramsey Road
Shirley, NY 11967

Email:

hope@nycancerfoundation.org

Fax:

(631) 569-8519

***IMPORTANT INFORMATION***

Application Requirements:

• Applications cannot be processed without a completed Patient Treatment Verification Form, which must be stamped by the treating oncologist. 

• Applicants diagnosed with Stage I–III cancer must be actively receiving treatment at the time ofapplication. Those diagnosed with Stage IV are not required to meet this treatment condition.

• The application must be signed by the applicant.  Unfortunately, we cannot accept signatures from social workers, family members, or other third parties. All required documents must be submitted before the application can be reviewed. Once your file iscomplete, it will be evaluated and presented to the Board for approval.
  

• All required documents must be submitted before the application can be reviewed. Once your file is complete, it will be evaluated and presented to the Board for approval.

Assistance Details: 

•  The New York Cancer Foundation provides financial assistance of up to $2,500 to cover one (1) month of non-medical household expenses.

• Please note that cash grants are not provided.

Rental Assistance Elligibility: 

• To be considered for rental assistance, you must submit one of the following: (Please note: cash rentpayments are not eligible for assistance.

• A current rental billing statement along with your two most recent rent payment receipts, OR a copy of your lease along with your two most recent rent payment receipt

(Please note: cash rent payments are not eligible for assistance.)

Expenses NYCF Does Not Cover:

• The Foundation can not provide assistance for the following:

• Medical bills

• Subscriptions

• Credit card payments

• Loans

• Copayments

Billing Information: 

• All bills must be in the applicant’s name

• Bills must be currently due or in arrears

• Please do not send any bills with your application.

• Payments will only be made after the application has been approved.

FINANCIAL & TRANSPORTATION ASSISTANCE OVERVIEW

Approved applicants may receive up to $2,500 toward eligible non-medical household bills (must be in the applicant’s name) and

up to $750 in transportation assistance through Uber Health for oncology-related appointments

Assistance may be provided for the following bills: 

• Rent or mortgage payments (applicant must be the lessee or homeowner)

• Utility bills (water, sewer, electricity)

• Phone bills (landline or mobile)

• Cable or internet services

• Car payments or car insurance

• Storage unit fees

• Life, Homeowner’s, or Renter’s Insurance 

**PLEASE NOTE: To qualify for assistance, all storage units must be physically located within New York State, and all car insurance policies must be registered in New York State. Payments for storage units or car insurance outside of New York are not eligible for funding. **

Bill Payment Process:

• Payments are made directly to the creditor. No payments will be made to the applicant.

• All bills received by Tuesday will be reviewed, processed, and mailed out by Friday—unless we have any questions or require additional information. 

 Transportation Assistance (Uber Health)

• The New York Cancer Foundation offers up to $750 in transportation assistance via UberHealth, exclusively for oncology-related medical appointments.

• Rides must be scheduled 1–3 days in advance of your appointment.

• You’ll receive ride confirmations and updates via text message or landline.

 You can send your completed application and required documents by:

Mailing Address:

New York Cancer Foundation -

20 Ramsey Road

Shirley New York, 11967

Email: hope@nycancerfoundation.org

Fax: (631) 569-8519

Office Phone Number: (833) 588-6923

**Applications WILL NOT be reviewed for Board approval until ALL documents are received**

DOWNLOAD OUR APPLICATION OR APPLY ONLINE TODAY!

Download PDF Apply Online

** After completing your application, email it and all supporting documents to hope@nycancerfoundation.org. For questions, call 1-833-588-6923**