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.