Dear Applicant,

Thank you for your interest in the Alabama Oncology Foundation’s (AOF) Patient Financial Assistance Program. AOF is a 501(c)(3) charitable organization whose mission is to Help Oncology Patients Excel during their fight against cancer.

Enclosed is the AOF’s application for financial assistance. Please note that applications must be submitted to AOF by a referring professional (i.e., your doctor, a nurse, social worker, patient navigator, or other health care professional who is involved with your care). Please read the instructions carefully and fill out the application completely. Also, be certain to list all current expenses and complete income information. AOF uses this information to gain a complete understanding of your current financial situation. Be sure to attach copies of the bill(s) that you would like the foundation to consider for payment as well as proof of income documents. Referring professionals are asked to mail a completed application to the following address or email address:

Alabama Oncology Foundation
500 Office Park Drive, Suite 400
Birmingham, AL 35223

OR email

Thank you again for your interest in the Alabama Oncology Foundation. Should you have any questions about this application, please call (205) 803-4330 or via e-mail at


Sincerely, The Alabama Oncology Foundation Board


Please download the below form and attach to your submission. Thank you.