FINANCIAL ASSISTANCE PROGRAM
BCFCF provides short-term, non-medical financial assistance to Central Florida area breast cancer patients, undergoing current treatment, who demonstrate financial need. Assistance may be provided for one or more of the following financial obligations:
- Complete the Financial Assistance Application and Medical Records Authorization forms online by clicking the button below or download and complete the Financial Assistance application and Medical Records Authorization and print, then return by email, fax, or mail to the Breast Cancer Foundation of the Ozarks office (BCFO is our parent chapter):
Email:
meagan@bcfo.org
Fax:
417.862.3830
meagan@bcfo.org
Fax:
417.862.3830
Address:
Breast Cancer Foundation of the Ozarks
620 W Republic Rd., Suite 107
Springfield, MO 65807
Breast Cancer Foundation of the Ozarks
620 W Republic Rd., Suite 107
Springfield, MO 65807
- Please be specific about what type of assistance is needed most.
- A copy of the most recent medical records related to your breast cancer treatment will be requested from your healthcare provider.
- Once the medical records are received from your healthcare provider, you will receive a phone call to confirm receipt of application and to obtain a short case history interview.
- Once all necessary information has been received, the Client Assistance Committee will review your request. All applicants will be notified of the committee decision via phone or mail immediately following a decision.
Typically, the entire process takes an estimated 2 – 3 weeks, however, all necessary information must be submitted before any request will be considered. The actual length of the process depends on how quickly the necessary information is received. All inquiries, applications and client files remain confidential.
*BCFCF does not assist with medical, cable, phone or credit card bills. All bills are paid to invoice (BCFCF pays the billing company directly).
Authorization for Release of Medical Records
PDF
At BCFCF, our goal is to ease the financial worries of families facing breast cancer. Our financial assistance program helps pay for household expenses while a breast cancer patient is in active treatment. BCFCF may be able to help you cover the cost of rent or mortgage payments, utility payments, car payments, car repairs, home or auto insurance, gas, or other necessary expenses. Please fill out this application to start the process. The client assistance committee meets once a month to review and approve cases. All inquiries, applications and client information remain confidential.