REQUEST SERVICE GUIDELINES
Our organization is designed to provide financial assistance for:
In order to qualify for our services:
- Children who are currently being treated with traditional medicine and are in need of or seeking integrated/complementary treatment(s) along with traditional medicine
- Children who are 0-6 months post treatment
- Children who are no longer in remission
In order to qualify for our services:
- You must be a resident of the United States
- Your child must be currently diagnosed with cancer or be 0-6 months post treatment
- Your child must be under the age of 18 years old
- You must be the parent or legal guardian of the child you are requesting assistance for
If you qualify for our program, please download and submit the completed "CRT Service" and "HIPAA Right Of Access" forms located below. Please note, we do NOT reimburse uninsured portions of Standard of Care (SOC) treatment expenses.
The forms can be submitted via email or mail.
Email:
[email protected]
Mail:
Cancer Response Team, Inc.
20235 N Cave Creek Road
Suite 104-184
Phoenix, AZ 85024
The forms can be submitted via email or mail.
Email:
[email protected]
Mail:
Cancer Response Team, Inc.
20235 N Cave Creek Road
Suite 104-184
Phoenix, AZ 85024
Forms to request our service:
| CRT SERVICE |
| HIPAA Right Of Access |
Please Note: In order for us to receive invoices or other information from medical third parties, a signed HIPAA release form is required by law to be provided to any third party. HIPAA is required by law to protect the privacy of families. CRT will not access your child’s medical records unless specifically authorized by you.
Cancer Response Team, Inc. is a 501(c)(3) nonprofit organization dedicated to helping children get supportive cancer care. We do so by providing their families with financial assistance for integrative and complementary cancer therapies from time of diagnosis up to six months post treatment.
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Disclaimer: Cancer Response Team, Inc. is not providing any medical advice and has no direct affiliation with any alternative treatment organizations/clinics nor treatment practices. All articles, links, media and associated content are offered strictly as an open resource through the freedom of information. All alternative treatment plans are determined solely by the recipient(s) and/or legal guardian(s) along with their selected alternative practitioner(s). CRT does not guarantee any results. It is highly recommended that Recipient/Legal Guardian prior to commencing or terminating any treatment discuss such with Recipient’s medical providers. Recipient/ Legal Guardian agrees to indemnify, defend and hold harmless CRT, its officers, directors, employees and volunteers against any and all claims, causes of action, damages, judgments, cost or expenses, including attorney fees and other litigation costs, which may in any way arise from recipient’s treatment plan.
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