Pink Fund Application FAQs
General
We always accept applications. However, you must be in active treatment throughout any funding.
To reach the application, please visit: https://pinkfund.org/financial-assistance-pre-qualification/ and answer the pre-qualification questions. If you meet our qualification requirements, you will be able to download and print the application. If you need help with printing, your medical support team may be able to help you. We cannot mail you an application.
Unfortunately Pink Fund’s financial assistance is only for those who live, work, file federal taxes, and receive treatment in the United States.
Pink Fund is not able to provide emergency assistance. If you have a social worker or patient navigator, they may be able to help.
Pink Fund is generally a one-time-only assistance program. If your situation changes, such as a re-diagnosis or recurrence, we may be able to help. Please email [email protected], and we will do our best to assess your circumstances and offer any available support.
If you are using our paper application, the application and documents must be mailed to us at P.O. Box 607, Southfield, MI 48037.
For tracking and accuracy, we only correspond through email. We cannot discuss anything regarding your application over the phone. Please feel free to reach out to us at [email protected] with any questions or concerns you may have, and we’ll be happy to assist you.
All organizations are different. Pink Fund is not a part of any other organization. You must apply to each separately.
Yes! We are happy to answer any questions you have. Please email [email protected]. We also have detailed videos available for each page of the application and for each document we require.
The Pink Fund Application Assistance Videos:
> Personal Information Form
> HIPAA Form
> Medical Information Form
> Medical Team Contact Form
> Financial Disclosure Form
> Employer Letter
> Doctor’s Letter
> Tax returns and W-2s
> Bank Statements
> Paycheck Stubs
> Bills
The week we receive your application in the mail, you will be sent an email explaining the process, with a timeline for how long it should take to hear back from us.
Patients must be in active treatment and experiencing reduced household working income throughout any funding. If you’ve completed your treatment, we unfortunately cannot approve your application, even if you were undergoing treatment when you sent in your application. We encourage you to explore other resources as you transition into the next phase of your journey.
Eligibility Guidelines
Patients or their spouse/partner must have been actively working at the time of diagnosis and able to show a loss of working income due to their breast cancer diagnosis. If you or your spouse/partner were not actively working, you do not qualify.
If you have questions regarding your eligibility to receive financial assistance, please email [email protected].
Yes. Patients or their spouse/partner must have been working at time of diagnosis and able to show a loss of household working income due to their breast cancer diagnosis.
If you have questions regarding your eligibility to receive financial assistance, please email [email protected].
Patients or their spouse/partner must have been actively working at the time of their diagnosis and must be able to show a loss of working income due to their breast cancer diagnosis and treatment. If you or your spouse/partner were not actively working, unfortunately, you do not qualify.
If you have questions regarding your eligibility to receive financial assistance, please email [email protected].
Employment
You can tell them you are applying for a grant, and need a letter stating the change in your employment status/work hours since a specific date (the date of your diagnosis.)
Click here to watch a helpful video on the Employer Letter .
Yes, but you should write the letter yourselves.
Click here to watch a helpful video on the Employer Letter .
Yes. We need a letter from all of the employers you and your spouse/partner had at the time of your diagnosis, stating the first and last dates you worked.
n the Employer Letter .
Medical Information
We must have start and projected end dates for treatment unless you have been diagnosed with stage IV metastatic breast cancer.
Click here to watch a helpful video on the Medical Information Form.
We understand that treatment plans can change. The Medical Information form should be filled out as completely as possible, with start and anticipated end dates for projected treatment.
Click here to watch a helpful video on the Medical Information Form.
We will accept this letter from your Oncologist, Patient Navigator, Nurse Navigator, or Social Worker.
Click here to watch a helpful video on the Doctor’s Letter .
We need both the letter from your doctor and the Medical Information form. If either of these is missing or not complete, we will not be able to approve your application.
Click here to watch a helpful video on the Doctor’s Letter .
Click here to watch a helpful video on the Medical Information Form .
Lab reports and office visit summaries are not an acceptable substitution for the letter from your doctor.
Click here to watch a helpful video on the Doctor’s Letter .
Bills/Financial Information
If our Qualifications Committee decides to fund a bill for you, we will write a check to each individual creditor, so we must receive copies of bills with your name or the name of a listed household member, your current address which matches the address on your application, the account number, the amount due, and the complete mailing address to mail the payment to. If ALL of this information is not included on the bill, we cannot pay it.
Click here to watch a helpful video on Bills.
We cannot accept a printout of an online account if it does not show all of the information we would need to write and mail a check.
Click here to watch a helpful video on Bills .
Pink Fund does not pay medical bills of any kind.
Pink Fund does not pay any credit card bills.
Pink Fund does not pay any personal unsecured loans or student loans.
We require a tax return from the most recent tax year (if it is after April 2024, we need to see your 2023 federal tax return; If it is after April 2025, we need to see your 2024 federal tax return). If you do not have a tax return, unfortunately, we cannot approve your application.
Click here to watch a helpful video on Tax returns and W-2s .
If you and your spouse/partner cannot provide clear documentation of your household income and how it has changed, we cannot approve your application.
We must receive clear documentation about your household income and how it has changed. If you and your spouse/partner don’t receive paycheck stubs from your own business, we can accept two months of complete business bank accounts with the income highlighted, invoices, receipts, etc.
Pink Fund does not send any money or gift cards to applicants. If our Qualifications Committee decides to approve your bills for funding, we will write checks and mail them directly to each of your individual creditors.
If our Qualifications Committee decides to approve your bills for funding, we will write checks and mail them directly to each of your individual creditors.
Click here to watch a helpful video on Bills .
For rent payments include ALL PAGES of your rental agreement/lease and the complete name and address to which payments can be mailed.
The Pink Fund Application Assistance Videos:
> Personal Information Form
> HIPAA Form
> Medical Information Form
> Medical Team Contact Form
> Financial Disclosure Form
> Employer Letter
> Doctor’s Letter
> Tax returns and W-2s
> Bank Statements
> Paycheck Stubs
> Bills