FINANCIAL ASSISTANCE
DOWNLOAD THE APPLICATION
English Application
Spanish Application/Aplicaciones en español
Vietnamese Application/Ứng dụng tiếng Việt
Submit your completed application by:
- Mail: Breast Cancer Solutions, 25422 Trabuco Rd. #105-167, Lake Forest, CA 92630
- Fax: 866-781-6068
- Email: application@breastcancersolutions.org (PDF only; no image files (e.g., .gif, .png)
- Please call 1-866-960-9222 if you have questions
READ BEFORE APPLYING:
- Financial assistance is only available in Orange, Riverside and San Bernardino Counties (California).
- Your current household income must not exceed 300% above the Federal Poverty Level (2026 Federal Poverty Level Guidelines)
- Submitting an application does NOT guarantee that you will receive financial assistance.
- Breast Cancer Solutions does not discriminate on the basis of race, ethnicity, color, religion, sexual orientation, sex, gender, gender identification, national origin, citizenship, veteran status, ancestry, age, physical or mental disability, or any other protected class or group.
You are NOT eligible for financial assistance if you:
- Live outside of Orange, Riverside, or San Bernardino County (California)
- Have completed your surgery, chemotherapy and/or radiation
- Have no evidence of disease
- Are taking a long-term hormonal treatment only (e.g., Tamoxifen) for stage I, II, or III cancer
- Are receiving hospice/palliative care only
- Are in the process of undergoing reconstruction but not receiving any other treatment
- Stop treatment for any reason against your doctor’s advice
- Have over $6,000 in liquid assets (does NOT include 401Ks, IRAs, vehicles or personal items)