Application

Applying is simple — and we’re here to help.

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, print, then return by email or mail to the Breast Cancer Foundation of Central Florida:

Email

alloyd@bcfcf.org

Address

Breast Cancer Foundation of Central Florida
3825 Florida Avenue South, Suite 4C
Lakeland, FL 33813

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 your healthcare provider sends the medical records, you will receive a phone call to confirm receipt of the application and to obtain a short case history interview.

Once the necessary information has been received, the Client Assistance Committee will review your request. Immediately following a decision, all applicants will be notified by phone or mail.

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).

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 help you cover 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.

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