|
Cancer Assistance Program (CAP)
Administered by
Putnam 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 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.
~~~~~~~~~~~~~~~~~~~~~~~
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
The Only Home Care Agency Located In Putnam County,
Serving Our Community Since 1966.
139 Court Street · P.O. Box 312
Ottawa, OH 45875 · 419-523-4449
The Putnam County General Health District is an Equal
Opportunity Employer.
|