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

Childhood Cancer Lantern
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Cancer Kids of San Joaquin County

Financial Support

What you get

Up to $2,000 during induction, consolidation, radiation, or surgery with at least $1,000 in travel costs; up to $1,000 during maintenance with at least $600 in travel costs. Open now.

Who starts it
You, with their part of the form from your social worker or doctor
How it’s sent
Email to don@cancerkidssjc.org
Your time
An hour or so, plus waiting for the form
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your child is 18 or under.
  • Treatment-phase tier and minimum travel expense apply.
  • Families may receive support every six months while the child is in treatment.

  1. Ask your social worker or doctor for their part of the formStart here. This is the part that takes the longest.

    Cancer Kids of San Joaquin County needs their part of the form from your social worker or doctor. It has to cover 5 things. Copy this message, or say it in person at the next visit.

    Hi [social worker’s name],

We’d like to apply to Cancer Kids of San Joaquin County’s Financial Support. They offer up to $2,000 during induction, consolidation, radiation, or surgery with at least $1,000 in travel costs; up to $1,000 during maintenance with at least $600 in travel costs, and they are taking applications now.

They need their part of the form from you or someone on the care team. It has to cover request for CKSJC financial-support help, our child name, treatment phase, requested expense categories, and available invoice or payment evidence. Their form and instructions are here: https://www.cancerkidssjc.org/resources

Could you do that when you have a chance? I’ll bring the printed form to our next visit, or I can email it. Thank you for everything you do for us.

[your name] · [phone]
    Copying is the only thing this page does with your text. Nothing is saved.

  2. Fill in their formPrint it, or fill it in on screen if the PDF allows.

    Open the application PDF ↗ Checked Aug 27, 2026

    What the form asks for

    Family, hospital, and assistance request
    Patient's NameAgeDiseaseParent's Name(s)Primary LanguageMother's CellFather's CellHome AddressCity, ZipApt. #HospitalSocial WorkerSW emailSW phoneGas Gift Cards - check preferenceGas Gift Cards - AmountHotels.com - AmountUber - AmountSafeway - AmountTarget - AmountFood 4 Less / Rancho San Miguel Markets - AmountStarbucks - AmountSubway - AmountMcDonalds - AmountIn-N-Out Burger - AmountTaco Bell - AmountOption #1: Payment will be made directly to health care or service provider - AmountOption #2: Payment made to parent or guardian for paid out of pocket expense - AmountTotal Amount
    Gift-card receipt signature
    Print NameRelation to childSignatureDate

    Have ready

    • Unpaid invoices when requesting direct payment to a health-care or service provider.
    • Paid invoices and proof of payment when requesting reimbursement to a parent or guardian.

  3. Email your application and their part of the form togetherTo don@cancerkidssjc.org. Your social worker or doctor can send it instead if their part of the form has to stay with them.

    • Email the completed Funding Request Form and any applicable invoice evidence to both don@cancerkidssjc.org and peggy@cancerkidssjc.org.

    Email: don@cancerkidssjc.org

    Subject: Financial Support application, [child’s name]

Hello,

Attached are our completed application and the form from [social worker’s name] at [hospital]. Please let me know that it arrived and if anything is missing.

Thank you,
[your name] · [phone]

After you send

Ask both CKSJC contacts to confirm receipt if no confirmation arrives; no response time is published.

Full record, as published