In order to formally apply for assistance from Remember Betty, a small amount of paperwork is required.
- Our completed application: Download Here ** Applications are accepted from the 1st through the 10th of each month only.
- A letter from your oncologist or surgeon that confirms your diagnosis of breast cancer, or a copy of your pathology report.
- A copy of the bill(s) that you are requesting assistance with, if applicable. Please note that bills need to include either pay by phone information or a payment slip to accompany a check. In the case of rental assistance, a copy of your lease must be included.
- A short personal note from the patient or survivor on how breast cancer has affected their life.
Assistance categories and caps are listed on our application. Please note that you may only select one category.
To submit your application, please follow the instructions on our application page. Applications are accepted via fax or mail.
To mail your application:
Attn: Review Committee
941 Wonderland Pass
Hermitage, TN 37076
To fax your applications: 615-634-1220
Incomplete applications will not be considered.
All applications MUST be signed by the applicant only. Applications signed by family members, social workers or patient advocates will not be taken in to consideration.
Please note that due to the volume of applications received, we cannot provide confirmation of receipt.
You do NOT need to be in active treatment to be considered for assistance.
Applications will be reviewed no later than the 17th of the month.
Applicants who are accepted will be notified no later than the 20th of the month via USPS mail. Assistance for those applicants will be disbursed no later than the end of the month.
Applicants who do not receive assistance will be notified no later than the end of the month via USPS mail.
Applicants may receive assistance that is less than the cap of a category based on the level of need shown.
Due to the volume of applications received, we cannot provide confirmations of receipt.
Inquiries on the status of an application will be answered after the 17th of the month only.
Applicants who receive assistance may reapply in twelve (12) months. Applicants who do not receive assistance may reapply after three (3) months time.
Please note that Remember Betty receives, on average, upwards of 200 applications per month. Our current funding allows us to accept between 5 – 10 applicants per month to assist. While we would love to assist every applicant who qualifies, it is simply not within our power to do so at this time. We are happy to suggest other organizations and resources to those applicants that we unfortunately cannot provide financial assistance to.