Welcome to The Leukemia & Lymphoma Society
Patient Financial Assistance Programs
Registration and Application Portal!
For your convenience, the Medical Healthcare Provider Portal will be available 24/7.
Medical Healthcare Providers:
Step 1: Register on the Portal
This portal is for Medical Healthcare Providers Only.
Medical Healthcare Provider members may include:
To Register : You must have a valid professional email address, a provider tax ID, and an NPI number. Once you submit your registration, you'll receive an email (typically within five minutes) directing you to a website to create your password. You can then begin entering applications.
Click Register, to begin the registration process for the Medical Healthcare Providers portal.
Step 2: Submit an Application
To submit an application, please click Start.
If this is your first time on the portal, be sure to register first.
Adobe Reader 9 or newer is required in order to properly display the forms that you can download. Please ensure that you have it installed prior to downloading any forms from the LLS Patient Center.
The following web browsers have been tested and are known to work with this site:
- Internet Explorer 8 or higher
- Internet Explorer 11 is not supported
- Google Chrome 30.0.15 or higher
- Firefox 4.0
- Adobe Reader 9 or higher version
- File size uploads are limited to 2MB
Newer versions of these should work without any issues. Older versions of these, or browsers not listed here, may work. However, if you experience any problems, please use one of the browsers listed above. Each one is free, widely available, and often pre-installed on many computers.
Please note: Cookies must be enabled. Cookies are usually already enabled, but refer to your browser's help documents for instructions on how to enable cookies if they are disabled. If cookies are not enabled, you won't be able to log in, and will see the log-in page repeatedly.