Patient Access Grant: Apply

Patient ACCESS Grant Application

Melanoma International Foundation established the Patient Access Fund in 2013 in memory of Patricia Garcia-Prieto .  Peggy Seaver is donating the matching grant in memory of her brother, Wesley Coyle, who dealt with many of these access issues before dying from melanoma.

Travel scholarships will be available to patients who have to travel more than 50 miles from their home to enroll in a FDA  or government approved clinical trial.

Eligibility and program guidelines are as follows:

√   Applicants must demonstrate financial need based on individual income tax return
√   Official documentation must be received from medical practitioner regarding  diagnosis
√   Applicants may apply prior to travel for pre-approval
√   Original receipts are required for funds disbursement

Program Guidelines

√   The maximum amount that can be awarded is $1500 within any 2 year period
√   Eligible expenses include transportation between a patient’s residence and medical facility
√   Also eligible are lodging and hotel costs
√   Not approved for reimbursement would include meals, entertainment, supplies, gas, car repairs, etc.

Note:  Scholarships are awarded on a first come first serve basis until funds are exhausted during the program year.

Selection Process

A review committee will look at each application and make a decision based on need. Applicants will be notified within 2-3 of application submission.

 

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UPDATED: August 7, 2013