Heartland Cancer Foundation
  • Apply
    • Eligibility
    • Online Application
    • Download Application
  • Give
    • Donate
    • Sponsor
    • Planned Giving
    • Fundraise
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  • Events
    • Mardi Gras Gala
    • Giving Tuesday
    • Give to Lincoln Day
    • Heartland Classic Mixer
  • Resources
    • Assistance Programs
    • Education
    • Support Services Directory
  • About
    • Our Story
    • Patient Spotlight
    • Meet our Angels
    • Board of Directors
    • Impact Guild
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Download Application


​Patient or providers must print the application and mail the completed application with income verification documents to the foundation office. Heartland Cancer Foundation will review the application on a rolling deadline to approve or decline your submission. Once a determination has been made, you will be notified by mail. Please make sure you have read and understand the Grant Restrictions, HIPAA, and Income Requirements.

To be eligible you must meet the Income Requirements and reside in one of the following counties:
Nebraska: Boone, Butler, Cass, Fillmore, Gage, Jefferson, Johnson, Lancaster, Nemaha, Otoe, Polk, Pawnee, Richardson, Saline, Saunders, Seward, Thayer and York.

Please note that to receive transportation assistance, you must travel at least 25 miles round trip to your treatments.
Download Application
©2021 Heartland Cancer Foundation. All rights reserved. Unauthorized use prohibited. 
​Heartland Cancer Foundation is a qualified 501(c)(3) tax-exempt organization.


  • Apply
    • Eligibility
    • Online Application
    • Download Application
  • Give
    • Donate
    • Sponsor
    • Planned Giving
    • Fundraise
    • Volunteer
  • Events
    • Mardi Gras Gala
    • Giving Tuesday
    • Give to Lincoln Day
    • Heartland Classic Mixer
  • Resources
    • Assistance Programs
    • Education
    • Support Services Directory
  • About
    • Our Story
    • Patient Spotlight
    • Meet our Angels
    • Board of Directors
    • Impact Guild
    • Community Partners
  • Contact