Circle of Hope provides financial assistance to those demonstrating financial need to help in receiving their cancer treatments. Those receiving financial assistance must either reside in the Santa Clarita Valley, work in the Santa Clarita Valley or be receiving treatment in the Santa Clarita Valley and be able to demonstrate financial need through their application and required documents. Financial Assistance recipients must be a US Citizen or permanent legal resident. Financial assistance is on a first come, first serve basis as funds are available and are for new medical expenses (co-pays, deductibles, medicine, COBRA & insurance premiums, second opinion, etc.) Circle of Hope funds will be utilized after all insurance and other payment resources have been used. All forms, applications and supporting documentation must be completed and received before an eligibility determination is made.

Application Packet Procedures

Fill out and complete all financial assistance forms and applications. A completed application packet, including all required documentation, must be mailed or dropped off in person to Circle of Hope. Send application packet to: Circle of Hope, Inc., 23033 Lyons Avenue, Suite 3, Newhall, CA 91321. No emailed or texted copies will be accepted.

An interview with a Circle of Hope, Inc. representative for clarification purposes and presentation of documentation is required. Our Client Services Director will contact you to schedule an appointment once your documents are received.

You will be notified in writing after your interview of your approval status or if additional information is required.

Please call Circle of Hope with any questions or assistance in filling out your application. We are here to help you.

Support for this program is based on the availability of funds. Circle of Hope
reserves the right to adjust or change criteria without notification.

Financial Assistance Checklist

COH Second Opinion Financial Assistance

Medical Release Authorization

Application for Medical Financial Assistance

Media Release Form

HIPAA Privacy Authorization Form

Client Bill of Right

Client Bill of Rights Acceptance and Agreement Form