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PATIENT ASSISTANCE

applying for ASSISTANCE

  1. Complete the Southeastern Cancer Care Application

  2. Provide Proof of Income (1 of the following)

* W-2's, 1099's or Schedule C's

* 3 months of consecutive pay stubs

* Letter from employer stating pay

* Copy of most recent bank statement

  3. A letter from your doctor verifying your current diagnosis and        detailing treatment plan.

 

Questions about qualifications or the application process? Call us at 919-587-9056 or email us at southeasterncancercare@gmail.com.

We Can Help With​

  • Gas

  • Groceries

  • Utility Bills

  • Oncology-Prescribed Medication

  • Do you have an active cancer diagnosis?

  • Are you undergoing radiation or chemotherapy?

  • Have you recently had oncology related surgery?

  • Do you live in Eastern North Carolina?

  • If so, we may be able to help you!

Disclaimer

Please allow 72 hours for your application to be processed. We are not an emergency fund and cannot provide immediate assistance. Please remember you must actively be on treatment to qualify for the program. If you are currently on treatment, please submit your application as soon as possible to ensure you meet all qualifications. If you have been charged with a felony or misdemeanor other than a minor traffic violation within the past 10 years, you will not be eligible for assistance. If you fail a drug test while enrolled in the program, your assistance is immediately terminated, and you will not be eligible to reapply.

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