The Head and Neck Cancer Alliance is proud to offer our Gas Card Program, which supplies a limited amount of BP and Exxon gas cards in the amount of $50.00 to head and neck cancer patients currently in treatment, to help with transportation costs. The $50 grant is a one-time offer to each patient and is open only to U.S. residents.
Requests for assistance through our Gas Card Program must come from a healthcare provider on behalf of a patient. HNCA cannot accept requests directly from patients. Please seek the assistance of your healthcare provider’s office, patient navigator, social worker, etc. to submit the online form.
PLEASE NOTE: Cancers of the brain, eye, esophagus, thyroid gland, and early cancers of the skin of the face and scalp are not classified as head and neck cancers for the purposes of gas card distribution.
Healthcare Providers, Navigators and Administrators: Please use ONLY the online form available below. Past forms (fax, scans, or paper) are no longer accepted.
When filling out the online application, please include ALL pertinent and correct patient mailing information, i.e., apartment number, etc. Many mailings are returned to HNCA due to lack of mailing address information or incorrect mailing address.
Please know that gas cards are only available when funds permit. We will provide an update to this page when funding for the year has been dispersed.
Submit all gas card questions to firstname.lastname@example.org.
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