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Medical Representative Access

Please Note:

We have reached our limit for enrollments in our Lazarex CARE travel reimbursement program for 2024 and have temporarily suspended accepting applications for the Lazarex CARE program. We depend on donations and fundraising activities to provide our patient services. This suspension allows us to work within our budget and helps to ensure that we have the funds we need to continue supporting our current Lazarex patients.

  • Patients who are currently enrolled in the Lazarex CARE program will continue to have expenses reimbursed. 
  • Given existing grant funds, Multiple Myeloma and Stand Up to Cancer applications will continue to be accepted.

The Lazarex Clinical Trial Navigation Program remains in operation and is accepting new questionnaires.

Financial Assistance Applications

These documents are for use by a Medical Representative only (social worker, clinical trial coordinator, doctor or nurse, etc.) and are password protected. We will continue to make changes to the documents so please return here to print the most current versions. Older versions of this application will slow the process.

If you are a patient, please contact Lazarex Cancer Foundation directly for assistance with clinical trial expenses or for help with clinical trial identification.