Assistance

Here are the Guidelines to Qualify.

• Northeast Florida or Southeast Georgia Resident
  Florida Counties: Duval, Nassau, Clay, St. Johns, Baker, Putnam, Flagler
  Georgia Counties: Charlton, Ware, Camden, Glynn
• Current Breast Cancer Patient

  You must be a diagnosed breast cancer patient and in active treatment during the time of nomination by a member of your Oncology team.

  Oncology team members can be a healthcare professional, social worker, or clinician.

  Active treatment is considered active chemotherapy, radiation, or a recent surgery.

1. You must contact a member of your oncology team about completing and submitting the application. (Patient required to sign Authorization for Disclosure of Protected Health Information)

2. Please have that member contact Edith Marie Foundation directly on how to apply and submit the application with supporting documents if applicable. (COPY OF BILL REQUIRED FOR HOUSING AND UTILITY PAYMENTS)

3. Funds are disbursed based on availability and are paid directly to the vendor or service provider as a one-time love grant. Once we’ve reached our maximum number of applicants that we can accommodate that month all applications will be notified by email and encouraged to reapply the 1st of the following month. Applications are submitted on the 1st of every month and must be submitted by the applicants of Oncology team.

Financial Application
Health Disclosure Form

Please send completed applications to applications@edithmarie.org.