How To Apply for Assistance

NCS Hope Foundation is committed to a clear application process.

Patients or providers seeking financial assistance for supportive services and resources may complete the online application or download a copy of the application and submit it via mail, email, or fax. NCS HOPE Foundation will review the application on a rolling deadline to approve or decline your submission. Once a determination has been made, you will be notified by mail.

Step 1:

Patient qualification relies on the following eligibility criteria:

  1. Currently a cancer patient and receiving cancer treatment in the state of Nebraska
  2. Meet household income requirements (see Income Requirements)
  3. At least one year since you qualified for assistance from NCS HOPE Foundation
  4. Must have read and accepted the Grant Restrictions

Step 2:

Gather information needed for the application

  1. Patient Information
  2. Household Income from all sources (recent income tax return(s), Social Security Award Letter, or most recent paystub)
  3. Expense information (copies of bills needing payment assistance)
  4. Health Statement (to be completed by a medical team member familiar with the patient’s cancer treatment)

Step 3:

Apply for Assistance

English Application
Aplicación en español

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