Many pediatric cancer families feel the financial strain of fuel costs when making multiple trips to treatment each month. Megan's Wings is here to help. Megan's Wings Gas Assistance Application can be submitted by a parent of a child currently in treatment for cancer or by a medical professional such as a social worker, child life specialist, nurse or doctor submitting the application on behalf of the family experiencing financial distress.  To qualify, the family must live 15 mi or more (one way) from the child's treatment and travel 4x/mo or more to treatment. Families living 45 miles or more, traveling at least 2x/mo also qualify. This program is open to any pediatric cancer kiddo living in and receiving treatment from a Hospital or Cancer Center located in Southern California. Families can qualify for up to $200 in gas assistance receiving a $50 gas card for up to 4 consecutive months. Applications are reviewed weekly and gas cards mailed directly to the family if approved. The program will stay open as long as funding is available. If you have any questions about our Gas Assistance Program, please call our office at (909) 532-8135.

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* 1. Is the child in active treatment for cancer?

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* 2. Does the family reside 15 or more miles from where the child receives treatment?

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* 3. How many times per month on average does the child travel to treatment?

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* 4. How much longer is the child expected to be in active treatment?

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* 5. Does the family drive their own vehicle to get their child to treatment?

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* 6. Patient's Name & Age

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* 7. Treatment Hospital

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* 8. Child's Medical Social Worker

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* 9. Child's Doctor

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* 10. Type of Cancer and Treatment Child is Receiving

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* 11. Contact Information

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* 12. Explain the parent's work situation and if parents have lost income due to the child's illness or COVID 19?

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* 13. Is the family receiving unemployment benefits or help from the federal stimulus package? Please explain. 

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* 14. Name & phone number of the person submitting this application.

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