CLIENT APPLICATION
DO I QUALIFY?
You must be in active treatment for breast cancer by receiving one or more of the following: chemotherapy, radiation, upcoming surgery (lumpectomy/mastectomy).
Must be a resident of or be receiving treatment in Larimer or Weld County.
Must be 18+ years of age.
NEXT STEPS
Submit your application
Online: Click BEGIN APPLICATION to complete online process
E-mail: Click DOWNLOAD APPLICATION and share to nikki@hopelives.org
Mail: Click DOWNLOAD APPLICATION, print, complete and mail to 2627 Redwing Rd, Suite 210, Fort Collins, CO 80526
Once your application has been received and accepted, our staff will be in touch to schedule an in-person orientation.
Finished with treatment, but still need help? Visit our services page to download a list of providers who specialize in clients with your unique needs and for a list of additional resources.
Also, check our home page for the current Survivor Speaker Series offering for clients just like you!
Contact our office at 970.225.6200 with any additional questions.
Visit our services page to view services by category offered through our program!