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Get Help

Apply for Assistance

Three short forms, one sitting. No account, no password, and nothing to pay. If filling in a form online is not for you, call (254) 202-8082 and we will do it together.

You don't have to use this form

Call or email and we will take your application over the phone, post it to you, or sit down with you at the office. It makes no difference to the help you get.

Call (254) 202-8082 info@wacocancer.org

Before You Start

What you'll need

Nothing has to be exact. If you do not have something to hand, leave it and we will fill in the gaps when we speak.

  • Your address, phone number, and date of birth
  • The type of cancer you are being treated for, and roughly when you were diagnosed
  • The name and phone number of the doctor treating your cancer
  • What medical insurance you have, if any
  • A rough idea of your household income and how many people live with you
  • The name of anyone who referred you to CCA

What Happens Next

Three steps, then a phone call

  1. 1 Send us your application Fill out all three forms below, in order, in one sitting. Your answers carry over from one form to the next, and everything is sent together when you press Submit on the last one. No account, no password, no login.
  2. 2 Terry reads it The Executive Director reviews every application personally and will normally get in touch within one to two business days.
  3. 3 We work out what CCA can cover We talk through your situation, what we can help with, and what we need from you. If we can help, we pay approved vendors — the pharmacy or supplier — directly.

How your information is handled

What you send goes to the Community Cancer Association office in Waco and is read by the Executive Director, Terry Hunt. CCA is a one-person staff — nobody else reviews applications.

Your medical and financial details are used only to work out how CCA can help and, with the HIPAA authorization you sign below, to speak with your pharmacy, physician's office, clinic, hospital, or an approved social service agency about the items we are paying for. Nothing is sold, published, or shared for any other purpose. You can withdraw that authorization in writing at any time.

The Application

Complete Your CCA Forms Online

Please fill out all 3 forms and submit. Start with the Application, continue to the HIPAA Authorization, then finish with the Terms of Service — all 3 are required, and they are sent together at the end.

Step 1 · Assistance Application

CCA Application 2026

Apply for help by sharing personal, financial, medical, and referral details used to determine eligibility and coordinate assistance.

Start Here: CCA Application

Step 2 · Medical Records Release

CCA HIPAA Authorization 2026

Authorize medical providers, pharmacies, clinics, hospitals, and social service agencies to release information needed for financial or medical assistance.

Open Form: CCA HIPAA Authorization

Step 3 · Terms Agreement

CCA Terms of Service 2026

Review and acknowledge the terms for receiving assistance, including eligibility, approved vendors, medication, supply, and travel guidelines.

Open Form: CCA Terms of Service

Not sure whether CCA can help?

Ask before you apply. There is no wrong way to start the conversation, and it costs nothing to find out.

Call (254) 202-8082 Read Common Questions