Request Assistance
Please fill out the form below if you are seeking Financial assistance from Families Raising Hope.
An individual seeking financial assistance must satisfy ALL of the following criteria:
Must currently be undergoing cancer treatment* (as defined below) at the time of application.
Must be financially constrained due to necessity and be willing and capable of furnishing documented receipts/bills (e.g., medical bills, utility bills, mortgage payments, etc.). Applicant must have a dire need* for financial assistance.
Must hold legal United States citizenship.
Must currently reside in Arizona (proof of AZ address is required).
Must submit a completed application and a verification of treatment form.
Note: The verification of treatment form must be submitted by the medical facility.
Disclaimer:
Approval of financial assistance is not guaranteed for all requests. The discretion of Families Raising Hope applies to all requests based on our ability to provide requested funds.
Definitions:
Current Cancer Treatment is defined by Families Raising Hope as the use of surgery, chemotherapy, radiation, medications, and other therapies to cure a cancer, shrink a cancer or stop the progression of a cancer.
Dire Need is defined by Families Raising Hope as a need that describes an extreme and immediate situation, rather than simple inconvenience.
Please note: Funds are limited and distributed based on need, urgency, and the availability of funds. Families Raising Hope reserves the right to limit or deny any funds based on the information provided. If false information is provided at any time during the process, FRH reserves the right to refuse a request. All funds must be used for the purpose applied for and will be paid directly to the institution or organization providing the services funding is applied to. Families Raising Hope also reserves the right to offer financial assistance in the form of a gift card if deemed appropriate. Any information provided to Families Raising Hope and its representatives will remain confidential and will not be shared with any agency or organization.