BHFA Screening Assistance Application




Patient Information




This is the address where the funding will be sent







Email address required. Patient Advocate email address cannot be substituted.






Advocate Information



For advocates: email cannot be the same as patient email






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Common symptoms of colon or rectal cancer may include:
  • change in bowel habits
  • feeling that your bowel does not empty completely
  • rectal bleeding or blood in stool
  • stools that are narrower than usual
  • persistent abdominal discomfort
  • weight loss for no known reason
  • weakness or fatigue
  • nausea and/or vomiting