Breast Health Fund Application Form
Please note: After submitting this form, you must also email copies of your relevant bills to [email protected]
The intent of the Breast Health Fund is to help cover the costs associated with outstanding bills relative to breast health treatment. It is open to patients all across the Upper Peninsula.
1. Acquisition of Information. We do not acquire any more information about consumers than is required by law or is otherwise necessary to provide a high level of service efficiently and securely.
2. Our Employees and Privacy. We train all of our employees about the importance of privacy. We give access to information about consumers only to those employees who require it to perform their jobs.
3. Security Measures. We make access to privacy-sensitive information subject to rigorous procedural and technological controls, consistent with legal requirements and the demands of customer service.
4. Disclosure to Third Parties. We will provide individually-identifiable information about consumers to third parties only if we are compelled to do so by order of a duly-empowered governmental authority, we have the express permission of the consumer, or it is necessary to process transactions and provide our services.
Donations are non-refundable