Financial Assistance Criteria


Click here for Financial Assistance Criteria

Click here for Financial Assistance Policy

Click here to download the Financial Assistance Application Forms

  • Please print these forms and fill them out completely. 
  • Bring the forms to Princeton Community Hospital's Patient Support Services Department or mail them to Princeton Community Hospital, Patient Support Services, P.O. Box 1369, Princeton, WV 24740.
  • If you need assistance, call 304-487-7566.
  • In order to apply for a Medicaid card, the patient will need a record of household income for the past three months along with their most recent bank statement.