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

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TOUCH Inc.

Financial Assistance

What you get

$150 or $175 monthly (sources disagree), up to 12 nonconsecutive months, for housing and insurance, utilities, phone, food, supplies, childcare, car bills, fuel, taxis, storage, and other approved nonmedical costs. Ask whether requests are open.

Who starts it
You, with a document from your doctor
How it’s sent
Email to contact@touchindiana.org, or by post
Your time
An hour or so, plus waiting for the document
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your income must be below 300% of the federal poverty level.
  • Your liquid assets must be below your estimated treatment-period expenses.
  • Assistance is discretionary and fund dependent.

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

    TOUCH Inc. needs a signed confirmation of the diagnosis from your doctor. It has to cover one thing. Copy this message, or say it in person at the next visit.

    Hi [doctor’s name],

We’d like to apply to TOUCH Inc.’s Financial Assistance. They offer $150 or $175 monthly (sources disagree), up to 12 nonconsecutive months, for housing and insurance, utilities, phone, food, supplies, childcare, car bills, fuel, taxis, storage, and other approved nonmedical costs, and we are checking whether they are taking requests.

They need a signed confirmation of the diagnosis from you. It has to cover future treatment plan overview. Their form and instructions are here: https://touchindiana.org/about

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

    Eligibility checklist
    I understand that TOUCH does not pay for medical expenses or credit card bills of any kindI live in Vanderburgh or Warrick CountyI am currently a cancer patient, diagnosed within six months of today’s date, or I am currently undergoing cancer treatments
    Personal, contact, insurance, and employment information
    Full NameDate of BirthSocial Security NumberStreet Address (must match your ID)CityStateZipHome PhoneCellWorkBest phone number to reach youBest time to callMarital statusAdditional Contact 1: Full Name, Phone, RelationshipAdditional Contact 2: Full Name, Phone, RelationshipHealth InsuranceInsurance CarrierInsurance provided throughEmployment status BEFORE your cancer diagnosisEmployment status AFTER your cancer diagnosisPlace of EmploymentDate of last Employment
    Show the rest of the form (3 more sections)
    Monthly household income and current assets
    Total # of People in Household; # of Wage Earners in Home; # of DependentsMONTHLY Income Sources (after taxes) — BEFORE Diagnosis and AFTER Diagnosis: your employment; other employment; Social Security; SSI/SSDI; employer disability insurance; unemployment insurance; spouse unemployment insurance; retirement/pension/401K/IRA/OAP; alimony; other investment income; other; monthly total incomeAre you currently enrolled in any of the following programsAdditional Liquid Assets: Cash / Checking Account; Savings Account; Life Insurance (Cash Value); Investments; Retirement Funds (If not currently retired); TOTAL ASSETS
    Monthly household expenses
    Transportation: Car Payment; Gasoline; Auto Insurance; Taxi / Other transportation feesOther: Groceries; Storage Fees; OtherUtilities: Electricity / Gas; Water; Sewer; Phone; OtherChild Care: Day care / babysitter / otherHousing: Rent / Mortgage; Home / Renters Insurance; OtherMedical Expenses NOT covered by Insurance: Copays / Coinsurance / Deductible Payments; Monthly PremiumsMONTHLY TOTAL ESTIMATED EXPENSEPrinted Name; Signature; Date
    Request for Medical Information / Patient Release and physician section
    I hereby consent for Dr. [name] to provide the information requested below to TOUCH INCPatient Signature (Parent or legal guardian if patient is a minor); DatePatient Full NameSpecific Cancer DiagnosisDate DiagnosedCancer treatment administered to date (check all that apply)Future treatment requiredIf YES, Plan overviewWill treatment require travel outside of Vanderburgh/Warrick CountyOther comments / Related expensesPhysician’s Name (Please print); DatePhysician’s SignatureOncology Treatment Center

    Have ready

    • Completed TOUCH financial-assistance application, including the signed acknowledgment.
    • Proof of physical address: a driver's license or other government-issued ID showing the application address, or a bill, pay stub, or bank statement showing that address.
    • Patient release at the top of the physician form, signed by the patient or by a parent/legal guardian if the patient is a minor.

  3. Email your application and the document togetherTo contact@touchindiana.org. Or post it to the address on the form. Your doctor can send it instead if the document has to stay with them.

    • Email family materials to contact@touchindiana.org or mail them to TOUCH Inc., 904 S. St. James Blvd, Evansville, IN 47714.
    • The physician instructions direct the completed medical section to the same email or mailing address.

    Email: contact@touchindiana.org

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

Hello,

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

Thank you,
[your name] · [phone]

After you send

Confirm receipt of both parts because the physician section may travel separately. Be prepared for a telephone or personal interview about treatment and financial status. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published