Ask Us for Help - Team CMMD Foundation

DIRECT-TO-FAMILYASSISTANCE PROGRAM

We are Back! I am happy to announce that we have opened up the ASK FOR HELP program. Team CMMD Foundation works to raise funds for local families living with cancer. For now, we are requiring that the “sponsor” or patient is a member of Team CMMD. Please specify the amount of financial assistance needed, our funds are limited but we will do our best to help. We can also offer your patient moral support in the way of a dedication run in their name and also send you a “No One Fights Alone” fleece blanket made with love by the youth of our organization. Please let us know if this is something we can do for them by reaching out to Kim Fuimano via email: kim@teamcmmd.org

Ask For Help

Your Name*
First Last
Your Email Address*
Your Address*
Street Address Address Line 2 City State ZIP Code
How can we help?*
Choose the best way that the Team CMMD Foundation can be of assistance to your patient in need. All requests will be reviewed by the Team CMMD Foundation board. Financial assistance amounts vary based upon needs. All financial assistance requests are kept private. Dedication Runs are held once per quarter and the coordinator will be in contact with you to schedule. Dedication Run honorees will receive a "No One Fights Alone" Blanket. Care Packs for Caregivers are prepared for caregivers and provide necessities like lip balms, coffee mugs, Wawa gift cards and more. Thank you!
- Financial Assistance - NOTE: Request will not be processed without letter of documentation
- Care Packs for Caregivers
- Dedication Run
- Dedication Run - Anonymous...in some cases the patient wishes to remain anonymous on our foundation communications but would still benefit from the support drawn from a dedication run or blanket
Name of Person to help*
First Last
Are you or the patient a member of Team CMMD?*
Email address of Person to help*
Address of Person to Help*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Cancer Diagnosis of Person to Help*
Treating Physician*
Please note treating physician(s) of patient. FOR ALL FINANCIAL ASSISTANCE REQUESTS, please send a note confirming diagnosis/treatment on physician letterhead to Team CMMD Foundation, 750 W. Lincoln Hwy, Exton, PA 19341 or secure email to teamcmmd@teamcmmd.org. We also accept documentation directly from patient caseworkers.WE WILL NOT BE ABLE TO PROCESS FINANCIAL REQUESTS WITHOUT DOCUMENTATION. Thank you!
Caseworker / Nurse Navigator*
Caseworker / Nurse Navigator Email Address
Age of Patient
Number of Dependents 18 years old and under*
Case Information*
Please describe patient's condition and specific need in as much detail as possible.
Degree of Need*
Please specify amount of monetary request as well as what the financial grant will be used for
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