I was very moved by the closeness of your family [on Good Day America] and how you are pulling together to bring good out of it. My heart goes out to her, to you, and especially to your children. It pains me greatly to see so much suffering and loss due to cancer. There is a great need for [The Jack & Jill Late Stage Cancer Foundation]. The Foundation will be hugely successful and supported beyond measure.
I am 38 year old single parent with two girls, ages 11 and 7. I was diagnosed with advanced cancer at the age of 37.
Ashley M., Baltimore
Referral Process and Eligibility Requirements
WOW! Experience program referral candidates must meet all eligibility requirements below before the oncologist can submit the referral.
If you are not a current Oncology Coaltion Partner, please complete the Coalition Partner Application.
All referral candidates must:
- Be referred directly from their treating oncologists
- Have late stage limited life expectancy cancer
- Have at least one (1) child age between the ages of three (3) and eighteen (18) - Only one child must meet the minimum age requirement
- Have a life expectancy more than two (2) months
- Have not participated in an any adult dream, wish, or any other similar program
Should your patient meet all eligibility requirements, please complete the following forms: Memory Opportunity Referral Form Part I and Memory Opportunity Referral Form Part II. Both forms must be completed and returned together by the treating oncologist.
Transportation restrictions apply. For more information, contact Heidi Cohen at 678-523-1001.