Click here for Financial Assistance Criteria
Click here for Financial Assistance Policy
Click here to download the Financial Assistance Application Forms
Click here for Financial Assistance and Uninsured Discount Policy Statement
- 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.