Application, Policy & Other Documents

How to Apply for Financial Assistance?

Financial Assistance Program Summary & Application – English

Which Doctors Are Not Covered by Our Financial Assistance Policy?

Listing of Doctors Not Covered by Financial Assistance Policy – English

Need a Copy of Our Financial Assistance Policy?

Financial Assistance Program Policy – English

How Do We Determine Amounts Generally Billed?

Basis for Calculating Amounts Charged to Patients – English

Hello, we are in the process of translating the documents on this website into Spanish and Creole languages. We expect the translations to be available soon. We apologize for any inconvenience.

Hola, estamos en el proceso de traducir los documentos en este sitio web a los idiomas español y criollo. Esperamos que las traducciones estén disponibles próximamente. Pedimos disculpas por cualquier inconveniente.

Alo nou nan prosè traduction dokiman sou sit entènèt sa a nan lang panyòl ak kreyòl. Nou espere tradiksyon en disponib byento. Nou eskize pou nenpòt deranje.