Application For Financial Assistance

"HAHCCS considers and/or reviews current/new financial assistance applications only between the dates of March 1st & November 1st annually.."

 

"Have a Heart Children's Cancer Society, user friendly Request Application for Financial Assistance is made easy in order to expedite the process.

 

This was designed to simplify the steps and allow social workers to fax the completed application directly to our corporate office for processing.  To submit the financial assistance application, please fax it directly to 631 223-3964. All applications must be filled out completely in order to be processed."

 

If you have any questions, please call (631) 470-1198.

 

CLICK HERE for the application - you will need Adobe Acrobat Reader to open the application. If you do not have the FREE Adobe Acrobat Reader click on the Get Reader box below.

 

 

 

ABOUT US

 

Have a Heart Children's Cancer Society was formed for the sole purpose of improving the quality of life for these courageous children and their families. Our team is dedicated to collaborating with hospitals, medical centers and other children's organizations to locate families who have financially fallen prey to this debilitating disease. Once identified, we are able to assist them with medical bills, treatments, equipment, transportation and household expenses.

HAVE A HEART is a Non-Profit Charity 501(C)3

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