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    Procedure for Assistance Request

  • Complete and submit the Application for Assistance Request Form and all required attachments. Applications will not be considered complete and reviewed until ALL supporting documentation is received or an explanation is received explaining any missing documents.

  • Complete the patient portion of the Diagnosis Confirmation Form and submit to your current treating physician’s office. The doctor will send the Diagnosis Confirmation Form directly to Tallapoosa’s Caring REFUGE.

  • The Board of Directors will review all applications for assistance and will make final selection based on availability of funds.

  • Selected applicants will be notified within 10 days once assistance is approved.

  • Once a recipient is chosen, funds will be disbursed directly to the vendor or supplier of these identified needs based on the availability of funds.

  • All applications will be kept confidential.


  1. Must be a resident of Tallapoosa County.

  2. Must have active cancer diagnosis and actively undergoing treatment.  (Diagnosis Confirmation Form and application must be completed and signed by both the patient and treating physician). 

  3. Applications will be reviewed by Tallapoosa’s Caring REFUGE's Board of Directors. 

  4. Applicants may re-apply for assistance every 90 days from the date of award notification.   If denied, patient may re-apply after 30 days from date of notification letter. Contact Tallapoosa's Caring REFUGE to re-apply by mail.



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