Apply for Assistance

Need Financial Assistance?

Patients currently undergoing cancer treatment in the Phoenix metro area can complete an application and a written form requesting assistance and it will be presented monthly to the board of directors for approval.

Arizona Assistance In Health Care, Inc. is a not-for-profit volunteer organization which assists cancer patients and their families with non-medical expenses when the cost of prolonged medical care creates financial hardship.

The organization does provide money for -
emergency non-medical expenses such as rent, utilities, car payments and various other needs.

The organization does not provide money for -
travel, medications, supplements, hotel accommodations and/or physician or hospital charges. Please see the Patient Application Guidelines for more information.

Please complete your application in its entirety for consideration. Financial assistance is not intended for monthly supplementation.

• Download the Assistance Application (PDF)

• Download the Assistance Application (Spanish/Español) (PDF)

Download the Patient Application Guidelines (PDF)

Adobe Acrobat Reader
is required to view the Application Package and Patient Application Guidelines. You can download a free version of Adobe Acrobat Reader here.

Mail completed application to the address below for consideration. If your application is considered you will be contacted by a representative from Arizona Assistance In Health Care.

Arizona Assistance In Health Care, Inc.
P.O. Box 5157
Goodyear, Arizona 85338

If you need further information, please call 623-207-3009 or send us an email and we’ll get back to you shortly.