Applications for Financial Assistance

Note: All links are to PDF documents. If needed, download Adobe Acrobat Reader.

Necessary documents:

1. HeathLink Checklist(95KB)

2. Financial Assistance Application(233KB)

3. Copies of government assistance notices (including Department of Health & Human Services Notice of Decision).

Other Documents:

4. Employment Verification(91.5KB)

5. Rental Verification(95KB)

6. Tax Return Request Form(58.3KB)