Guide for Approval
Eligibility for the program is subject to certain conditions and acceptance is made on a case-by-case basis. Grants are restricted to patients who are citizens of the United States and legal residents of the state of Texas, currently under the care of a licensed physician for the treatment of leukemia.
All applications MUST be filled out completely and signed by the patient, the patient's attending physician, AND an additional member of the medical staff that can attest to the patient's diagnosis (i.e. Social Worker, Financial Advisor, Practice Manager, Nurse Practitioner). Late, incomplete, unsigned or illegible applications will not be accepted. For questions regarding your patient aid application, please call Leukemia Texas at 214-265-7393 or email us at firstname.lastname@example.org.
Patients receiving aid from Leukemia Texas may receive financial assistance from other agencies, but not for the same services or invoices. Patients receiving Federal, State, County or Local aid or Social Security, Medicare or Medicaid may be eligible for aid.
By accepting Leukemia Texas aid, all patients agree that acceptance of financial aid is subject to the availability of funds and patients’ compliance with the terms and conditions of the Leukemia Texas Patient Aid program. Patients further acknowledge and agree that Leukemia Texas reserves the sole discretionary right to change or amend the terms and conditions of the Patient Aid program or terminate a patient’s participation in the program.
Leukemia Texas does not discriminate based upon age, race, gender or creed.
Scope of Assistance
The Leukemia Texas Patient Aid Program provides funding for the treatment of leukemia as prescribed by a licensed physician and that is not paid for by insurance or any other third party.