Nadine whitlock hayes
legacy fund

Help for families
with high risk cancer

Nadine Whitlock Hayes left her earthly life in 2014, after being diagnosed with breast cancer in 2011. She lived an amazing life as a single mother raising 9 children after her husband died from Hodgkin's disease. One daughter preceded her in death, also from breast cancer, and a son died from pancreatic cancer subsequent to her death. Her other 7 children 18 grandchildren, 19 great-grandchildren and a host of nieces, nephews and cousins cherish memories of her nurturing and are grateful for the life lessons she taught of strength, service and giving. One of her grandsons, William T. McClure, Jr., has established the Nadine Whitlock Hayes Legacy Fund to honor her by helping families who experience financial burdens as a result of breast cancer. He has chosen to partner with the Pink-4-Ever to manage the fund and to distribute donations from the Nadine Whitlock Hayes Legacy Fund to eligible patients, survivors and their families. Donations to this fund are used exclusively to help families with the cost of recommended genetic counseling and testing for breast cancer and to provide financial assistance to patients and survivors to help ease financial burdens caused by their diagnosis and treatment.

All requests for Nadine Whitlock Hayes Legacy Fund must come to Pink-4-Ever via our universal application. Because of the demand for assistance, oral requests cannot be accepted. Incomplete applications also cannot be considered. Our funds are limited; therefore, the more information that we have the easier it is for us to make good and timely decisions regarding assistance.

It is our goal to provide an answer regarding assistance as soon as possible. Please allow two business days for medication requests and up to 5-7 business days for other types of assistance.

Candidates must apply online for assistance. Once the application, and supporting documentation, have been submitted, your file will be reviewed by the Executive Director. The Executive Director will present the file to the Board of Directors for review and consideration for approval.

PLEASE NOTE: The Board of Directors meets (once a month) or (on the third Thursday of each month). Requests for assistance must be received by the third Monday of each month, in order for them to be reviewed and considered for approval by the Board on the third Thursday. Once the Board of Directors has made a determination, the candidate will be notified within 1-3 business days.

To qualify for assistance from Pink-4-Ever, you must meet the following eligibility criteria and provide the following documentation:

• You must have written documentation of breast cancer diagnosis from your oncologist stating what your current treatment is. We will send the oncologist our Letter of Diagnosis form to be filled out.

• You must be a resident of Indiana. Please bring your picture I.D with current address.

• Your current monthly income must be $ (this figure is subject to change based on annual review by our Board of Directors). Please provide current proof of monthly income, such as a printout or award letter from State Disability, DWD, Social Security, or General Assistance, or a bank statement showing direct deposits. If you have no income, a social worker can attest to that for you in a letter.

Once all required documents have been provided and your Pink-4-Ever, Inc. file is complete, you are eligible to receive a grant for financial assistance for up to $800, or for medical costs up to $1,500 for bills no more than 30 days old. The exact figure and type of assistance, will be determined by Board of Directors. Financial assistance may be used to pay for items such as:

• Rent

• Utilities (gas, electric, water)

• Phone

• Medical Insurance Premiums

• Medical Expenses not covered by insurance

• Pre-arranged funeral costs (payment can only be made prior to a client’s death)

The funding for Pink-4-Ever,Inc. is limited. Every attempt is made to use funds to cover urgent needs. Pink-4-Ever, Inc. currently does not pay storage or relocation expenses, gym memberships, cable TV bills or other non-emergency services. In Indianapolis food may be provided by Gleaners Food bank.

Generally speaking, clients are eligible to re-apply for additional assistance twelve months or more after the date of their last grant. Because eligibility criteria may change, clients should be prepared to provide new documentation (including a new letter from their doctor, current identification, and proof of income and current lease) at the time they reapply.

PAYMENT BY PINK-4-EVER

Payments made by Pink-4-Ever on behalf of clients are ONLY to the actual provider of goods or services (landlords, utility companies, medical provider, etc.). Funds are never made directly to the client. Pink-4-Ever can pay only the client’s share of these expenses. Pink-4-Ever can make rent payments only to the actual owner of the property, not to friends or roommates. Please bring a copy of the lease or rental agreement showing your name, address, rental amount, the owner's name, owner's address, and the signatures of both parties. For bills other than rent, please bring the complete utility or medical bill, including the payment stub. In order to maintain client privacy regarding diagnosis or medical condition, checks issued by Pink-4-Ever do not have the agency name or telephone number printed on them, but do include the client’s name and vendor account number whenever possible. Checks are mailed directly to service providers and/or property owners.