NCCSF Application for Financial Assistance

Application for Financial Assistance

FUND PURPOSE: To assist individuals and their families with expenses that are related to an abnormal breast or cervical finding, who need related screening tests as recommended by their provider, and to offer financial support for costs incurred from treatment, travel, or other expenses related to the diagnosis of cancer. ELIGIBILITY: *Assistance will depend on the availability of funds, which are donated monies. *Individuals who have exhausted other programs and who reside in Teton, Pondera, Toole, Liberty, Chouteau, and Glacier counties. *Individuals and their families will be connected to other local resources that may be available.
Teton County Health Department

905 4th St. N.W. Choteau, MT 59422

Office: 406-466-2562 Cell: 406-750-7803

Fax: 406-466-5292
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Application for Financial Assistance