​The Ryan Lee Holland Cancer Foundation is currently NOT accepting applications for assistance. Please come back at a later date to submit your application for assistance.
Financial Assistance Program

The RLH Foundation Financial Assistance Program was established in August, 2011 to help patients and their caregivers who are dealing with a cancer diagnosis. We believe in the idea that all patients deserve the type of care and a quality of life that helps to promote and improve their mental and emotional health.  Our Vision is to alleviate the financial burden of a cancer diagnosis.  To help alleviate some of the financial burden associated with cancer treatment, our Financial Assistance Program distributes $100.00 grants to cancer patients in active treatment who are in need of financial assistance. 

The Financial Assistance Program is based on a referral from a medical professional such as a Doctor, Nurse, or Social Worker.

Applicants requesting financial assistance must:
  • Have a cancer diagnosis and currently in active treatment for their illness
  • Not have received financial assistance from  the RLH Foundation within the last 12 months
  • Live in Georgia or Michigan.
  • Complete the application form in its entirety. Only completed applications will be considered
  • Have your doctor, nurse, or social worker complete the appropriate section of the form
Applications are processed on a first come first served basis, as long as funding is available. When your application is received a member of our staff will verify the information and a check will be mailed directly to the patient. 
  
Financial assistance will be awarded to assist with the following expenses:
  • Medical Co-Pay
  • Office Visit Co-Pay
  • Prescriptions
  • Travel Expenses for Treatment  (transportation or gas)​
patient_assistance_application-2014.pdf
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File Type: pdf
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WAYS TO SEND YOUR APPLICATION: The Foundation is currently NOT accepting applications for assistance. Please come back later when we are accepting applications.

By Email: info@ryanleehollandfoundation.org

By Mail: 
                 Ryan Lee Holland Cancer Foundation, Inc.
                         11877 Douglas Road Ste. 102-262
                                    Alpharetta, GA 30005

  By Fax: 678-288-7949    
 
ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED


 © 2013 Ryan Lee Holland Foundation - All Rights Reserved                                           Last edited 3/6/2013