The quickest and most secure way to enroll a patient with the foundation is to use the online process or you can call and speak with a Co-Payment Specialist. Our toll-free number is 866-552-6729.
However, if you prefer to download and print an enrollment form, click here to download our enrollment form. Once completed, you can mail or fax the form directly to:
CancerCare® Co-Payment Assistance Foundation
275 Seventh Avenue, 22nd Floor
New York, NY 10001