菜单 关闭

患者援助表格

财政援助申请

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.

患者导航调查表

本表用于协助进行临床试验导航。 如果您希望我们帮助您或代表他人确定癌症临床试验方案,请使用此表。 

如果你有问题 ,请 联系Lazarex癌症基金会,以获得临床试验鉴定方面的帮助。

Complete the Patient Navigation Questionnaire

审判核查表 (TVF)

使用此表格來驗證已獲批准和已登記的Lazarex患者的癌症臨床試驗狀況。 请医疗代表(肿瘤学家、护士、医生、社会工作者或临床试验协调员等)填写此表。

患者有责任在要求的截止日期前将填妥的表格提交给Lazarex癌症基金会。 

如果你有问题,请直接联系Lazarex癌症基金会寻求帮助。

点击这里访问在线试用验证表  

患者导航调查表
Lazarex癌症基金会批准和加入的患者的试验验证表