Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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The Blood Cancer Foundation of Michigan

Holiday Toy Assistance

What you get

Holiday toys for you after enrollment. Open now, for this season only.

Who starts it
You
How it’s sent
Email to patientservices@bloodcancerfoundationmi.org
Your time
An hour or so
Last checked
Aug 27, 2026

Before you start, check you fit

  • The form asks for a health professional's contact information.

  1. What their form asksA preview, so you can gather things first. Fill it in on their site.

    Open the application PDF ↗ Checked Aug 27, 2026

    Send it by email to patientservices@bloodcancerfoundationmi.org.

    What the form asks for

    Patient information
    Today’s datePatient’s Last Name: First: MiddleMr. / Miss / Mrs. / MsMarital statusHome PhoneCell PhoneEmailCurrent Treatment StatusPreferred Method of ContactBirth dateAgeSexPatient isStreet AddressCityStateZipMichigan County of ResidenceRaceEmployment: (If patient is a child, please list parent/caregiver employment info)Veteran StatusHousehold Income Level: (For informational purposes only. Services are not based on income.)
    Medical & insurance information
    DiagnosisDiagnosis DateBone Marrow/Stem Cell Transplant DateTreatment CenterCityStateHealth Professional ContactTitle/PositionPhone NoDoes the patient have insurance? (Please include Medicare/Medicaid)Primary Health InsuranceSecondary Health Insurance
    Show the rest of the form (2 more sections)
    Referral and caregiver information
    How did you hear about BCFM’s servicesName of Primary CaregiverRelationship to PatientAddress: (if different from patient)CityStateZipHome PhoneCell PhoneEmailShould this person be the primary contact instead of the patient
    Additional family information, needs, and certification
    Total Number of People in Household: ChildrenTotal Number of People in Household: AdultsList Names/Birthdates of Children Still Living in Home (other than patient): Name / DOB / SexAny additional information on your current needsSignatureRelationship to PatientDate

    Have ready

    • Completed and signed 2026 BCFM enrollment form.

After you send

Save a copy and delivery evidence; call (800) 825-2536 if confirmation is not received.

Full record, as published