Applying for Assistance
Have you or a loved one been diagnosed with cancer? Carbon County Ribbons of Hope may be able to offer assistance. Please submit your information using our Financial Assistance Form below and we will get in touch with you as soon as we can. Thank you for helping us help others in Carbon County!
To apply for the Carbon County Ribbons of Hope Financial Assistance program, please download the forms below to your computer, print them off and mail them to us at P.O. Box 613, Rawlins, WY 82301.
Please note that Carbon County Ribbons of Hope respects your privacy; this information will not be shared with any outside party. At this time, Carbon County Ribbons of Hope is only available to offer assistance to individuals residing in Carbon County, Wyoming. By submitting this form for additional information, you understand that this does not guarantee that financial assistance will be provided. In addition to completing the form below, we will also need a signed letter from your oncologist indicating that he/she is treating you for cancer.
To apply for the Carbon County Ribbons of Hope Financial Assistance program, please download the forms below to your computer, print them off and mail them to us at P.O. Box 613, Rawlins, WY 82301.
Please note that Carbon County Ribbons of Hope respects your privacy; this information will not be shared with any outside party. At this time, Carbon County Ribbons of Hope is only available to offer assistance to individuals residing in Carbon County, Wyoming. By submitting this form for additional information, you understand that this does not guarantee that financial assistance will be provided. In addition to completing the form below, we will also need a signed letter from your oncologist indicating that he/she is treating you for cancer.
| financial_assistance_for_cancer_patients.pdf |