Apply for Services

In partnership with a team of outstanding local wellness professionals, CWC provides free-of-charge integrative therapies to those facing cancer on Cape Cod and the Islands.

Who can apply

Cape Wellness Collaborative serves people on the Cape & Islands with a cancer diagnosis who are currently undergoing or recovering from cancer treatments such as radiation and/or chemotherapy.  We also serve patients who are receiving cancer-related palliative care and people who have had positive genetic testing results for inherited cancer risk and are undergoing prophylactic surgery such as mastectomy and or oophorectomy.

Currently, we offer the following therapies / services:

  • Acupuncture

  • Art & Music Therapy

  • Chiropractic

  • Craniosacral Therapy

  • Energy Work

  • Lymphatic Massage

  • Massage

  • Meditation

APPLICATION STEPS

1

Fill out the online application.

(You may also print and mail your application or apply by calling our office at 774-408-8477).

2

Our CWC client care representative will be in contact to answer any questions you may have.

3

Approved applicants will be mailed a Cape Wellness Card with an initial value of $250, which can be used with any of CWC’s participating practitioners.

 

Application

Note: If you have received services through CWC in the past and are looking to add more funds to your Wellness Card, you do not need to complete this application. Please call us at 774-408-8477 or email us (please be sure to include the best number at which to reach you), and someone from our client care team with be in touch with you as soon as possible. 

Part 1.  ONLINE APPLICATION FOR CWC SERVICES

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How did you hear about CWC?
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Would your personal caregiver like for our caregiver specialist to reach out to them?

As part of our Wellness Cares initiative, Cape Wellness Collaborative is affiliated with Certified Caregiving Consultant™ Louisa Stringer. Providing your caregiver’s name and contact information will allow Louisa to reach out on your behalf with more information about our free caregiver support services.

What is your current treatment plan? Check all that apply.

Are you interested in receiving organic, nutritionally-crafted prepared meals? If yes, you may qualify for our WellnessEats program.

As part of our Wellness Eats program eligible clients can apply for a 4-week program which provides delicious, organic, nutrient-dense, ready-to-eat meals, free of charge. Our current program includes 3 meals a week for 4 weeks, for both the person facing cancer and their caregiver. To be eligible for our Wellness Eats program, clients must meet the following criteria:

  • Currently receiving active cancer treatment (i.e. chemotherapy and/or radiation treatment) and/or are less than 1 month post-surgery

  • A resident of Cape Cod

  • A Cape Wellness Collaborative recipient

  • Have no known dietary allergies or food aversions

Are you interested in group yoga classes? If yes, you may be interetsed in our Wellness Moves program.

I give Cape Wellness Collaborative permission to contact my oncologist or medical professional to  confirm a recent past or present cancer diagnosis or a confirmed genetic predisposition.

The mission of Cape Wellness Collaborative is to provide complimentary/integrative therapies to people in our community facing cancer. We require all clients applying for services to consult with their primary oncologist before starting any and all therapies. If your application for services is accepted, we will provide you with a link to a list of vetted practitioners – and a system by which to pay them for any services you select. The mention of any product, service or therapy is not an endorsement by Cape Wellness Collaborative, nor is it intended to substitute for the medical expertise and advice of your primary health care provider and/or oncologist.

 

Cape Wellness Collaborative does not discriminate in its programs or activities on the basis of race, color, national or ethnic origin, ancestry, age, religion or religious creed, disability or handicap, sex or gender, gender identity and/or expression, sexual orientation, military or veteran status, genetic information, or any other characteristic protected under applicable federal, state or local law.

RELEASE AND AGREEMENT

The undersigned client requests the assistance of Cape Wellness Collaborative, Inc. (CWC) in identifying providers (hereinafter "Provider(s)") of services including, but not limited to, acupuncture, massage, meal services, nutritional counseling, Reiki, meditation and yoga (collectively "services"), so that such Providers can render services to the Client. I understand that CWC does not, in any way provide actual services.

 

Client hereby acknowledges and understands that CWC makes referrals only to Providers who are licensed and insured in their respective fields. Client acknowledges that they should consult with their medical professionals regarding the appropriateness of the requested services.

 

In consideration of Cape Wellness Collaborative identification of possible Providers:

 

a) After consideration of the risks inherent in Providers services, Client fully assumes any and all risks associated with Clients' participation in any and all Provider services, and;

 

b) Client further agrees to waive and release any and all claims that Client or their respective heirs, have, or may have in the future, against CWC, its agents, servants, directors, officers and employees for any losses, damages, expenses, or injuries, including death, suffered from, or in any way, in connection with Clients' participation in any and all Provider services.

Part 2. SURVEY

We ask that you complete the following baseline survey as part of your application. The information you provide is completely confidential and will help us improve our services.

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In this questionnaire you will be asked about your symptoms. Would you please, for all symptoms mentioned, indicate to what extent you have been bothered by it, by selecting the number (1 - 4) most applicable to you. 

1 = not at all

2 = a little

3 = quite a bit

4 = very much

PLEASE ONLY RESPOND WITH A NUMBER (1, 2, 3 or 4) AND NOT A TEXT ANSWER

Have you, during the past week, been bothered by:

A number of activities is listed below. We do not want to know whether you actually do these – only whether you are able to perform them presently. Would you please mark the answer that applies most to your condition over the past week.

1 = unable

2 = only with help

3 = without help, with difficulty

4 = without help

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Would you please check whether you answered all the questions?

Thank you!

Our CWC client care representative will be in contact to answer any questions you may have.