Financial Aid Application
MTAC believes no woman should ever have to ask themselves can I afford to survive.
Guérir en Communauté - More Than a Cure MTAC's (hereinafter "MTAC") Financial Assistance Program was created to address the financial impact of a breast cancer diagnosis on patients. The program provides up to $2,000 per individual on a one-time basis via gift certificates directed towards basic needs (ex. food, pharmacy costs, hospital transport, etc.) to provide some relief of the economic hardship being faced.
STEP 1
Download Medical Information Form and send to medical professional to fill out
CLICK TO DOWNLOAD
STEP 2
Collect all necessary documents
* View Supporting Documents section below.
STEP 3
Complete Application Form below
ELIGIBILITY REQUIREMENTS
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Breast cancer Diagnosis: Must be in active treatment (surgery, chemotherapy, radiation or immunotherapy) or within 12 months of having completed treatment.
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Immigration Status: Canadian citizenship, permanent resident or asylum-seeker.
DISLAIMER
By completing the following form, you agree to communicate the information contained within the form and the supporting documents with MTAC, and for the said information to be used internally for the purpose of determining financial aid and internal statistics. The information will remain strictly confidential and will not be shared with third parties, unless pre-approved by the Applicant, and solely for the purpose of providing adequate services. Should information be used for statistical purpose s, it will be confidential and separated from the identity of the Applicant.
For more details, please see our terms and conditions, and privacy policy.