Financial Assistance

Financial Assistance is sponsored by The Gail Robinson Fund. Offers financial assistance to breast cancer patients and their families to help with medical bills, treatments, and other related expenses.

Guidelines for Grant Applications to The Gail Robinson Fund 1. Grants may be made up to $5000 per applicant but approval and amounts granted are subject to the availability of Funds and the priorities listed below. 2.

Priority for grants from the Fund will be given to grant requests for breast cancer patients residing or receiving treatment in the Montgomery County, Maryland, area. Applications outside this geographic area will be considered as Funding may be available. 4.

Grant applications (download below) must be supported with a signed statement from the treating provider attesting to the patient's diagnosis and treatment. In addition, a referral or recommendation from a hospital or oncology practice nurse navigator, social worker, practice administrator or other professional familiar with the patient's circumstances should be submitted to assist in the evaluation of the grant application.

All materials in support of an application will be kept confidential. 5. We encourage anyone with questions about the Fund, or potential grants from the Fund, to contact the Fund Administrator, Steve Larsen at gailrobinsonfund@gmail.

com 6. Completed paper applications, along with the provider verification form and the recommendation/referral form if applicable must be mailed or sent Fed Ex or UPS (not emailed) to: 7. Applicants may follow up a mailed application with a short email to the Fund with contact information notifying the Fund that an application has been mailed to the Fund.

the Application, Physician Verification, and Referral FORMS Gail Robinson Fund Application (pdf) Physician Verification Form (pdf) Referral - Recommendation Form (pdf)