FINANCIAL ASSISTANCE

 

READ BEFORE APPLYING:

  • Financial assistance is only available in Orange, Riverside and San Bernardino Counties (California).
  • Your current annual household income must be at or below 300% Federal Poverty Level (click for chart with details)
  • 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)

Application
Download the
Application in English
Download the  Aplicacion en Espanol/Application in Spanish
Download the  ĐƠN XIN HỖ TRỢ TÀI CHÍNH/Application in Vietnamese

Submit your completed application by:

  • Mail: Breast Cancer Solutions, 25422 Trabuco Rd. #105-167, Lake Forest, CA 92630
  • Fax: 866-781-6068
  • NEW EMAIL ADDRESS: application@breastcancersolutions.org (no image files please; do not use any other email address)
  • Please call 1-866-960-9222 if you have questions

Financial Assistance Application Request

Please send me an application by

11 + 7 =


Contact Us

Call us at 866.960.9222 or click HERE to use our convenient contact form.