Below you will find three links to documents regarding financial assistance:
- A Notice of Availability of Charity Care/Financial Assistance (pdf)
- An Application for Charity Care/Financial Assistance (pdf)
- Instructions for applying for Charity Care/Financial Assistance (pdf)
Please read the first item – the Notice of Availability of Charity Care/Financial Assistance. After reading it, if you believe that you would qualify for our charity program, please proceed to the second item – the Application for Charity/Financial Assistance. Please fill out the application and refer to the third item – the Instructions, with any questions on completing the application.
We must receive this completed application and all requested documents within 14 days of receipt of application. Send the application along with a copy of all required documents that apply to your family/household unit to this address:
Attn: Financial Services Office
P.O. Box 10005
Florence, AL 35631
If you need help completing your application and would like to speak with a Customer Service Representative/Financial Counselor, or if you would like to make an appointment to come in and speak with someone in person, please call 256-768-8323.