About Us>What We Do>Living Beyond Breast Cancer Fund>Verification of applicant diagnosis instructions > Verification of applicant diagnosis form
Please double check the spelling for your patient’s full name and date of birth prior to submitting. Typos and inconsistencies may affect whether the patient is selected for a grant.
Unfortunately, this patient is not eligible. LBBC does not consider Stage 0 (DCIS) for the LBBC Fund. For information about additional financial assistance programs, please visit our financial assistance page. We hope your patient finds these resources helpful as they navigate their treatment journey.
Please provide your name and contact information
Thank you for completing this form. If you have questions, please contact us at (855) 807-6386, press #1 or grantinfo@lbbc.org. Please note for your records the name of the patient(s) for whom you have completed a healthcare provider verification form.
Please double check the spelling for your patient's full name and date of birth prior to submitting. Typos and inconsistencies may affect whether the patient is selected for a grant.
Additional information about the Living Beyond Breast Cancer Fund can be found at lbbc.org/fund.
