Patient Contact Form

The Max Foundation provides access to life-extending medications, diagnostics, and care for people living with cancers and diseases in low- and middle-income countries. To connect with someone at The Max Foundation regarding your situation, please complete the form below.

Note that if you’re reaching out on behalf of someone living outside the USA, please select the country they are in from the drop-down.

Country*
Country
Name*
First Last
Email*
Reason for contact*
- I am a patient or inquiring on behalf of a patient.
- I have a general inquiry for The Max Foundation.
Message*

To make a donation, click here.

To mail a donation:
The Max Foundation
1448 NW Market St.
Suite 500
Seattle, WA 98107

For press inquiries, please reach out to news@themaxfoundation.org.