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 Circle of Hope is a member of the Minnesota Better Business Bureau Association since January 7, 2016.
Circle of Hope, Non Profit Organizations General Membership, Duluth, MN

Circle of Hope has its financials on Guide Star:

This is not the application below:

Where does Circle of Hope get their money from? Small and Large Grants, Designated Donations, 
Fundraisers. Often times the money is donated for a specific need. 

Where do the referrals come from? From doctors, physicians, oncologists, nurse navigators, social
workers, cancer centers, financial workers, TV ads, and other advertising.  

Policy: With the paper application given to you by your medical provider,  we will need the first page
of your income tax and a letter from your medical provider. The letter must state that you are in active
breast cancer treatment. That would be surgery, radiation, chemo treatments.

The grants are $500.00 if approved by the Board of Directors. WE DO NOT HAVE MONEY FOR ALL

We do not pay the patient, only the bills. Gas and grocery cards are mailed to patients when they are not 
available from their medical provider or other resources.  Medical bills would first through your insurance,
second through your medical provider. We are a 3rd payee. Most  medical providers have Financial Assistance
programs based on income.  

The help is income based and based on those who are really struggling. For example, they have had to
quit work to receive treatment. They have not gone on social security disability and are stage IV. 

This would be those individuals who fall into the poverty guidelines and/or have financial distress due to their breast
cancer medical, dental and prescription bills. The patient must apply. Call 1.218.464.1626 to have an application sent
to you. These payments will be be paid directly to the providers for the following services: dental (from not having teeth
fixed before chemo and they need to be pulled), prescription providers, mastectomy products (Heide's), St. Luke's Clinics/
Hospitals, Essentia Clinics/Hospitals, and all independent regional clinics/hospitals in northern MN and northern WI from
documented bills. Circle of Hope only pays for breast cancer treatment services that are incorporated businesses after they
have been run through insurance and community care programs. Circle of Hope does not pay patients.There is no 
guarantee that there are funds available in your county. It all depends on donors and fundraising that has taken place.  
That is why it is important to call, talk to the coordinator and get the application. 
What is Covered?
-These block grants are for breast cancer treatments. It could include related loop hole prescription coverage, dental
work related to chemo (so that ones teeth doesn't rot out from having chemo), bone infusions, lab work, surgery, 
reconstruction of the affected breast (s), radiation, chemo, physician (oncology, surgeon, radiation) bills related to all
of the above. These bills must be related to breast cancer treatment. These payments are based on "Needs" and Not 
Wants. (Proven treatments and medical procedures that are needed and highly recommended should be included.)

Daily Living Expenses as a rent payment, house payment, utility payment. We do not pay car payments, cell phone
bills. Gas or grocery card. The total amt. cannot exceed $500.00
Who Qualifies For Financial Help?
-Children, teens, women, men, and women who have breast cancer and can verify their financial need based on poverty
guidelines and/or financial distress.
How Does One Get Selected for A Breast Cancer Block Grant?
The Circle of Hope board will be evaluating and voting on these applications based on "a financial/needs criteria grid.
"For confidentially, the board has decided that the secretary  (coordinator) will be the only one who knows the name 
of the individual who have submitted applications. We do not ask for individuals ages.  Each application is assigned number.
How Much Are The Block Grants?
The block grants are breast cancer medical bills up to $500.00. Please only apply once a year, unless asked to do so again.  
(We do not plan on holding on to our financial resources, as no one is paid a salary.)

How Much Are Daily Living Grants?
These are based on real need and can be up to $500.00 if available for that area. All donations are for designated areas by
the donors.

If I Do Not Qualify; How Can I Get Additional Help With Other Financial Resources or a Benefit?
For those who do not qualify, we can still help you with resources. You can look under our Resources tab on our website,
which is constantly being updated with additional resources. There are local people who can help you as well. We have
many other resources other than those listed on our website. Just call our secretary, Peggy at 1.218.464.1626 (office).

You must go through a medical provider such as a cancer team social worker, nurse navigator, etc.


Name (Full Name)
Maiden Name and/or Other Names
I herby request and authorize the disclosure of the following information to the Circle of Hope as part of my application for support services. Yes or No
I hereby authorize the disclosure of the following information to necessary staff and board members of Circle of Hope. Yes or No
Medical records and services received related to the funding request. Yes or No
Intake/Admission Information. Yes or No
Other (Please specify) Yes or No
Client's signature:
The Full Date of the Application:
Enter the code shown:

Full name
Full and complete address
Telephone number
E-mail address
A provider who we can contact
Annual gross family income for the past year
Please state your financial need area
Why you need the money
Last 4 of your social security
What other financial resources have you tried to access for your bills
Are you involved with any other organization that can help you financially
Have you asked other organizations for help
Have you had a benefit or are you planning a benefit
Are you covered under health insurance
What type of health insurance do you have
What is your deductible
Do you pay house payments on your home
Have you enclosed a photocpy of your bill to be paid
What is your net income
How many people live in your home
Please sign your name or send your signature in the mail, if you are unable to do it electronically
Enter the code shown: