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

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Cancer Aid Resource & Education, Inc.

CARE Support Program Patient Aid

What you get

Help with nonmedical needs such as food, nutrition supplements, gas, lodging, and treatment travel. The amount isn't published. Ask. Ask whether requests are open.

Who starts it
You, with a document from your doctor
How it’s sent
PDF form, sent the way they ask
Your time
About 15 minutes, plus waiting for the document
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your child is 17 or under.
  • Treatment must be active and fit the published categories.
  • Assistance is fund-dependent.

  1. Ask your doctor for the documentStart here. This is the part that takes the longest.

    Cancer Aid Resource & Education, Inc. needs 2 things from your doctor. It has to cover 3 things. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to Cancer Aid Resource & Education, Inc.’s CARE Support Program Patient Aid. They offer help with nonmedical needs such as food, nutrition supplements, gas, lodging, and treatment travel, and we are checking whether they are taking requests.

They need 2 things from you: a note confirming the diagnosis and a signed confirmation of the diagnosis. It has to cover diagnosis and pathology timing, active treatment and schedule, and work, diet, and exercise fields. Their form and instructions are here: https://carelascruces.org/application-for-patient-assistance/

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

    Patient application and initial request
    Patient name, address, city/state/ZIP, residence/ownership and housing payment, utility-bill and residency-proof status, phones, date of birth, age, sex, email, emergency contact, marital status, spouse/partner, parent/guardian for a minor, family advocate/caregiver, education, race, ethnicity, veteran status, and prior CARE assistanceType of cancer, new diagnosis or recurrence, diagnosis date, stage, pathology-report date, primary-care physician and phone, treatment center, oncologist and phone, active-treatment status, expected treatment duration, and current treatment typeEmployment status, occupation/employer, primary-income-earner status, short-term disability, salary or hourly rate, sick leave, continuing salary, return-to-work expectation, spouse/partner employment, one-income household, Medicaid, Medicare, retirement income, SSD/application status, other agency assistance, and agency namesSelect the top three requested supports: gas cards, food/nutritional supplements, self-pay health insurance, vehicle payment, utilities, rent, mortgage, telephone, internet, fitness/gym membership, or other considerationMonthly household gross and net income before diagnosis and currently, including patient and spouse wages, other household income, pension, Social Security, disability, unemployment, public benefits, child support/alimony, business/self-employment/rental income, and other supportMonthly household expenses before diagnosis and currently: housing, utilities, food, vehicle/gas, phone/cable/internet, self-pay health insurance, life insurance, childcare, household items, other expenses, cancer medications, and cancer-treatment copayments/share of costWhy has your income or expenses changed during treatmentOther health conditions and medication cost; household size, number and ages of children; children outside the household; savings, stocks, property; retirement/life-insurance types; and health-insurance type/company/case managerPer-appointment oncology, chemotherapy, radiology, and radiation costs; yearly deductible; and maximum yearly out-of-pocket costLetter of the challenges, you and your family, are currently facing and how CARE can helpOther Consideration - Item: Please provide request in writing for considerationPrinted Name of Patient or Guardian; Signature; DateRequest-form patient name and date of birth; active-treatment type; vendor/creditor, account-holder name, due date, account or invoice number, and amount for each bill; or food/gas card selection and amount
    Treating physician certification · your care team fills this in
    Patient name, date of birth, phone, address, diagnosis date, cancer diagnosis, stage, new diagnosis/recurrence/follow-up status, active-treatment status, and pathology-report diagnosis datePatient's Estimated Treatment Plan and Schedule: surgery date; chemotherapy number, frequency, start and end dates; radiation number, start and end datesEmployment activity suitable for patient, projected return-to-work date, diet/food restrictions, and whether an exercise or fitness-gym program is recommendedTreating oncology/radiology/surgery physician name, social worker name/phone/email, physician license number, hospital/clinic, address, phone, and faxSignature of Treating Physician; Date

    Have ready

    • Copy of the patient's valid identification.
    • Copies of current insurance cards.
    • Doña Ana County residency proof: mortgage or rental payment receipt, utility bill/receipt, or voter card.
    • Current water or gas bill listed by the packet checklist.
    • Most current federal income tax return, or state return if no federal return is filed; the form instructs the applicant to black out the Social Security number.
    • if there is no income, a support letter from a friend or family member.
    • Two current months of checking and savings account statements;.
    • Bills for requested vendor payments, listed in due-date order; rent requests also need the landlord's W-9 and rental agreement.
    • Applicant letter describing the challenges the patient and family currently face and how CARE can help.

  3. Send it the way they ask

    • Call CARE at 575-652-5407 or 575-649-0598 for current submission instructions, then drop off the complete application, all three signed forms, and every checklist document.
    • Do not alter the official PDFs; use the ordered answer sheet and transfer answers to the printed forms.

After you send

CARE reviews the packet and calls to set an appointment; incomplete applications are not considered. If approved, complete a new Patient Request for Financial Assistance Form and obtain a new physician active-treatment certification for every later request. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published