Apply For Help
The Cancer Care Centers of Brevard Foundation (CCCF) offers financial assistance to pay non-medical living expenses for qualified patients undergoing active cancer treatment.
What do we pay?
- Utilities (water, sewer, electric, phone, etc.)
- Transportation (to and from treatment)
To qualify for assistance, you must:
- Live in Brevard County, Florida
- Be in active treatment for your cancer
- Have an annual income at or below 250% of national poverty level
- Complete the application form in its entirety.
- Fax (321-952-8830) or scan and email to firstname.lastname@example.org
- A copy of your most recent pay stub, unemployment check, or SSI, SSD, public assistance benefit notification or bank statement.
- If you do not have income, provide a letter of support from friend or family member.
- A signed letter from your oncologist that verifies you are currently undergoing active treatment for cancer.
- You will be contacted within 7-10 days. Note: Submission of an application does not guarantee approval.
- If you have questions about this form or need assistance in completing, please call 321-952-8837.
All information is strictly confidential and for CCCF use only.