Emergency Grants for Pancreatic Cancer Patients

Application Process

Step 1: Complete Emergency Grant Application Form

Step 2: Provide patient information (or both applicant and patient information if applying on behalf)

Step 3: Submit required medical documentation

Step 4: Submit financial documentation

Step 5: Submit personal statement

Step 6: Confirm attestation and consent

Step 7: Wait for contact (usually within 72 hours)

Step 8: Participate in Zoom call with Purple Pansies team to discuss needs and finalize assistance

Required Materials

Medical Documentation:

Letter from healthcare professional confirming pancreatic cancer diagnosis

Confirmation that patient is currently undergoing treatment

Maximum file size: 256 MB

Financial Documentation:

Letter of support from patient's case worker, social worker, or family member describing current situation

Proof of financial status (e.g., most recent tax return page one with SSN blanked out, or income verification such as social security statement)

If unable/uncomfortable providing above, brief statement outlining alternative verification methods

Maximum file size: 256 MB (financial docs), 10 MB (support letter)

Maximum file size: 256 MB

Form Sections Required

1. Patient Information:
- Full name, phone, email, address, date of birth
- Current healthcare provider
- Date of pancreatic cancer diagnosis
- Pancreatic cancer stage

2. Applicant Information (if different from patient):
- Full name, phone, email, address
- Relationship to patient

3. Financial Need:
- Primary need category and amount
- Secondary need category and amount (optional)
- Tertiary need category and amount (optional)
- Written description of needs in order of priority

4. Household Financial Information:
- Approximate annual household income
- Previous monthly household income
- Number and ages of dependents
- Proof of financial status

5. Personal Statement:
- Additional information applicant believes should be considered
- How applicant heard about emergency grants
- Confirmation of accuracy and consent

Submission Format

• Online form with file uploads
• Rolling basis (no set deadline)