CARING, SERVING, SUPPORTING
Patient Aid Application

2016-2017 Patient Aid Application Q4.pdf

Grants are restricted to patients who are citizens of the United States, legal residents of the state of Texas, and currently under the care of a licensed physician for the treatment of leukemia. 


  • There will be no exceptions for late or incomplete applications. 
  • Please read the directions carefully and complete all areas of the patient aid application. 
  • Written notification of the STATUS of your application will be sent within 3 weeks of the quarterly deadline.