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Dear Applicant, Please read and follow instructions carefully.
RCCS was established primarily to pay for the health insurance premiums of cancer patients. (RCCS does not assist in paying for co-payments, deductibles, doctor visits, etc.)
Please complete and mail the application to the address above along with the following supporting documentation:
1) Patient’s medical info. (Diagnosis, prognosis, pathology report)
2) Attestations from clergyman with whom patient is affiliated.
(Must have signature and notarization)
Upon receipt of your complete application, our Board of Application Approval will evaluate the application and inform you of patient’s eligibility.
IMPORTANT: APPLICATIONS WILL NOT BE CONSIDERED UNLESS THE ENTIRE APPLICATION IS COMPLETE AND ALL OF THE SUPPORTING DOCUMENTATION IS ENCLOSED.
WITH BLESSINGS FOR A SPEEDY AND COMPLETE RECOVERY.
Download application here:
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