BCRC provides guidance, education & assistance to those living in 
Travis, Williamson, Hays, Bastrop & Caldwell counties. 

               Complete this intake and privacy policy form and let us know how we can help you.



Please provide your name and contact information below. 



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In the event that BCRC must telephone the client for purposes such as appointment cancellations or reminders, or to give/receive other information, efforts are made to preserve your confidentiality. Please list your preferred phone number and how you would like us to identify ourselves. For example, you may request we call you at home or work, but not say the name BCRC or the nature of the call, leaving only the first name of the staff person calling. If you do not provide this information to us in the area below, we will adhere to the following procedure when making phone calls: First we will ask to speak to the client (or guardian) without identifying the name BCRC. If the person answering the phone asks for more identifying information we will say that it is a personal call. We will not identify BCRC (to protect confidentiality). If we reach an answering machine or voice mail we will follow the same guidelines.














Data collected for grant purposes only & to see if you qualify for financial assistance.





Examples of barriers the BCRC can help you overcome: 
- Financial Concerns                                         - Diagnosis and treatment education        
- Transportation assistance                               - Communicating with loved ones
- Funding for mammogram/ultrasound/biopsy   - Need for prosthesis/wig/post-surgical garment