Cancer Assistance Program


Administered byPutnam County HomeCare & Hospice Auxiliary
Putnam County HomeCare & Hospice is proud to support the Putnam County community through a Cancer Assistance Program.  The auxiliary began the CAP program in January 2004.  The purpose of this program is to reimburse residents of Putnam County who are receiving active treatment for their disease. 

Our Mission -  To improve lives of cancer patients and their families who live in Putnam County. 
Financial Assistance Includes -
• Reimbursement for prescription expenses related to treatment, including chemotherapy, radiation and cancer related medications which are not covered by insurance.
• Reimbursement for mileage to and from treatments.
• Financial assistance for supplies associated with having cancer, such as, nutritional supplements, wigs, and medical supplies.
How Do I Apply For Help?
• A one-page form must be completed for either mileage reimbursement, supplies or medication assistance. 
• The form includes a section to be signed by the treatment center personnel or physician’s office verifying these treatment dates.
• Visits to physician offices, other than for chemotherapy and/or radiation treatments, will not be covered.
 
How Much Can I Be Reimbursed?
• Reimbursements for mileage to and from treatment center/physician's office. 
• Medication assistance will be given for both active and extended treatments.   
• Reimbursement for miscellaneous supplies associated with your cancer diagnosis. 
• Submit completed form to below address or fax number.

Download Transportation Reimbursement Form


Download Transportation Reimbursement Form - for Miscellaneous VISITS
Download Supply Reimbursement Form
Download Medication Reimbursement Form
FUNDING - Cancer Assistance Program is a non-profit service that is funded by memorials, donations, fundraisers and grants. 


GIVING TO THE CAP PROGRAM IS EASY - 100% of your donation to the Putnam County Cancer Assistance Program will be used to provide financial assistance to patients and their families who are affected by cancer and who are residents of Putnam County.   Please make all checks payable to Putnam County Cancer Assistance Program.  All contributions are tax deductible.  Please include the following information with your donation:
• Name of who donation is in Memory of or in Honor of;
• If you would like an acknowledgement sent, we will need their name and address;
• Amount you wish to donate and if you enclosing a check, please make all checks payable to Putnam County Cancer Assistance Program. 
  Please mail this information to the following address:


Putnam County HomeCare and Hospice Auxiliary
Cancer Assistance Program
P.O. Box 76
Glandorf, OH  45848


CONTACT: For more information or to request a form, stop by or call:
Putnam County HomeCare & Hospice Auxiliary
139 Court Street - P.O. Box 312 Ottawa, OH 45875 Phone: 419-523-4449 Fax: 419-523-6328 Email: pchh@bright.net
CAP A service of Putnam County HomeCare & Hospice Auxiliary and United Way of Putnam County