CCCP Request for Travel Assistance

SPIPA’s Cancer Programs help with transportation so people can get the care they need. We support individuals who have been diagnosed with cancer and are currently receiving treatment by helping them travel to medical appointments. We also help eligible community members travel to cancer screening appointments. Eligibility depends on age guidelines for each type of screening. Each program year, you may receive up to $150 in Visa gift cards to help cover travel costs for cancer screenings and/or treatment.

We recognize that travel to appointments can sometimes be a barrier and a financial hardship. If this applies to you, please fill out this form. Please note that by completing this form, you are providing consent for us to contact you for additional information or to enroll into the NWWP program.
1.By completing this form, I agree to be contacted by the SPIPA Cancer Programs staff and/or NWWP Patient Navigator who may ask for additional information in order to provide enrollment and/or travel assistance.(Required.)