Triage Cancer Materials Request Form
Please complete the following request form to order educational materials from Triage Cancer.  Please allow for 2-3 weeks for materials to arrive.  For questions, please email info@TriageCancer.org. 

Please note: the materials listed below are the ones currently available for shipping. You can also print copies of these materials from our website. To see the full library of resources visit http://triagecancer.org/quickguides.

If you would like fewer than 25 copies of a resource, please consider printing them from the website, to help us save on shipping costs. Thanks!
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First Name *
Last Name *
Hospital/Organization *
Shipping Address: Street Number and Name *
City *
State *
Zip code *
Email *
Phone Number (for questions) *
Please share how these materials will be used. *
Guides, Quick Guides, & Checklists - Please identify the quantity that you are requesting, by topic. If you would like custom amounts, please note amounts below.
25
50
Other (more than 50 - please indicate # below)
Accessing Medical Records
ADA & Reasonable Accommodations
Appeals: Individual & Employer Plans
Avoiding Financial Toxicity - Checklist
Caregiving
Chemo Brain
Crowdfunding
Disability Insurance
Disclosure, Privacy, and Medical Certification
Estate Planning
Finding Financial Help - Checklist
FMLA Extended
Getting & Paying for Prescription Drugs
Getting Organized - Checklist
Health Insurance Basics
Health Insurance Marketplaces
Health Insurance Options
Health Insurance Comparison Worksheet
How the FMLA Works with Other Benefits
Legal Assistance
Life Insurance
Managing Medical Bills
Medicaid (currently out of stock)
Medicare 2023
Medicare Basics (Medicare Extended)
Medicare Plan Comparison Worksheet
Medicare Savings Programs
Medigap Plans
Navigating SSDI & SSI
Options When Losing Employer-Sponsored Health Insurance (currently out of stock)
Reasonable Accommodations - Checklist
Returning to Work
SSI
Timing of SSDI & Medicare Benefits
Custom amount requested
Spanish Quick Guides & Checklists - Please identify the quantity that you are requesting, by topic. If you would like custom amounts, please note amounts below.
25
50
Other (please indicate # below)
Disability Insurance
Estate Planning
FMLA Expanded (Currently out of stock)
Finding Financial Help
Health Insurance Basics
Managing Medical Bills
Options When Losing Employer-Sponsored Insurance
Reasonable Accommodations Checklist
Custom amount requested
Practical Guides to Cancer Rights - Please identify the quantity that you are requesting, by topic. If you would like custom amounts, please note amounts below.
25
50
Other (please indicate # below)
Practical Guide to Cancer Rights: Navigating Employment, Insurance, & Finance
Caregivers: Practical Guide to Cancer Rights
Young Adults: Practical Guide to Cancer Rights
Seniors: Practical Guide to Cancer Rights
Spanish - Practical Guide to Cancer Rights
Spanish - Caregivers: Practical Guide to Cancer Rights
Custom amount requested
Flyers - Please identify the quantity that you are requesting, by topic. If you would like custom amounts, please note amounts below.
25
50
100
Other (please indicate # below)
Information Sheet on Triage Cancer
2023 Webinar Flyer
Custom amount requested
Postcards - Please identify the quantity that you are requesting below.
25
50
100
CancerFinances.org
Animated Videos (English & Spanish)
MyHealthCareFinances.com
Clear selection
Custom amount requested
Drug Discount Cards - Please identify the quantity that you are requesting below.
25
50
100
Drug Discount Cards
Clear selection
Custom amount requested
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