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?

The New York Cancer Foundation is a private 501(c)(3) nonprofit organization dedicated to helping cancer patients across New York State focus on their treatment by easing financial burdens.

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 residents 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.

2026 Poverty Guidelines for the 48 Contiguous States

Persons in Family – Poverty Guideline 400%

1 – $63,840
2 – $86,560
3 – $109,280
4 – $132,000
5 – $154,720
6 – $172,600
7 – $200,160
8 – $222,880

DOCUMENTATION CHECKLIST 

Required documents for applicant and spouse or significant other:

• Complete the application form, ensuring that page 7 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. 

• 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)

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, including their NPI number.

  • Applicants diagnosed with Stage I–III cancer must be actively receiving treatment at the time of application submission. 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 is complete, it will be evaluated and presented to the Board for approval.

  • Detailed information regarding required documents can be found on Page 4

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  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.

  • Transportation Assistance - The New York Cancer Foundation offers up to $1,000 in transportation assistance via Uber Health, exclusively for oncology-related medical appointments within a 25 mile radius of your starting location.

Expenses NYCF Does Not Cover

• Medical bills/ Prescriptions

• Subscriptions

• Credit card payments

• Loans/ Tuition

• Co-payments

** Please note that cash grants are not provided. **

• Billing Information

• All bills must be in the applicant’s name

• Bills must be currently due or in arrears - we are not able to make future payments to provide a credit.

• Please do not send any bills with your application. Payments will only be made after the application has been approved.

Approved applicants may receive:

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  Up to $2,500 to cover one (1) month of non-medical household bills (must be in the applicant’s name).

  • Assistance may be provided for the following bills in the applicant’s name:

    • 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 payment

    • Auto, home, and life insurance (one month premium only)

    • Storage unit fees

      • **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. **

    • Rental Assistance Eligibility (Once Approved)

      • After approval you will need to submit a current rental billing invoice from your property management company along with your two most recent rent payment receipts, OR a copy of your lease along with your two most recent rent payment receipts.

      • CASH rent payments are not eligible for assistance.

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.

You can send your completed application and required documents by mail, e-mail or fax:

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

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**