Enrolling for Assistance
Islands Against Cancer (IAC) provides service and navigation support for patients who are in need. IAC has streamlined its enrollment process so patients can receive determination of eligibility for financial and program assistance. Click through the tabs for important information and to apply today.
Patient Portal
When our Patient Portal is complete, you will be able to login online to upload your Enrollment and other Forms and to see up-to-date information about your IAC status.
Welcome to Islands Against Cancer, a non-profit organization whose support assistance programs provide individuals diagnosed with cancer the opportunity to get assistance they need to help improve their quality of life.
In order for us to begin the process of qualifying you for support assistance, please read the following information and then click the APPLY Tab to complete the online application.
Upon receipt of your submitted application, Islands Against Cancer will determine if you are eligible for our programs assistance based on our Program Guidelines. To verify household size and household income Islands Against Cancer may perform a soft inquiry with a third-party vendor in order to determine eligibility. This inquiry can only be viewed by you (the patient) on your credit history and will not affect your credit score. We will advise you of the final outcome.
If you qualify, we will provide you with support service assistance through our programs.
Please understand that all approvals are on a first-come, first-served basis. Receipt of application does not guarantee program support.
Please call us at 843-327-0813 if you have any questions or need assistance filling out the following enrollment forms.
Sincerely,
Islands Against Cancer, Inc.
A 501(c)(3) Non-Profit Organization
- Patient must be diagnosed with a covered disease and program must be accepting enrollments.
- Patient must have a valid Social Security number to apply for assistance and receive treatment in the United States.
- Patient must be seeking navigation and other assistance for treatment or services covered diseases
- Patient income level must meet program guidelines.
- Patient contact and demographic information
- Diagnosis
- Prescribing physician’s name and phone number
- Estimate of patient’s household income and household size
If you have read the enrollment information and have all the documents/information ready, click below to complete the enrollment form: