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Applying for Financial Assistance

Download Financial Assistance Application 

Patients residing in the Central Washington Hospital service area (Chelan, Douglas, Grant, Okanogan counties and the city of Othello) who feel that they may be eligible may apply for the Financial Assistance Program.

The application must be filled out in its entirety, signed by the responsible party and returned within 60 days, or it will be denied. A copy of the application can be downloaded by clicking the button to the right.

Each patient will have an initial determination done prior to sending the application and will be reviewed for other programs prior to the sending of the Financial Assistance application.

Final Determination

Central Washington Hospital will notify the applicant of its final determination within fourteen (14) days of receipt of the completed application and all required supporting documentation material. A patient may appeal a denial of eligibility for compassionate care by providing additional verification of income or family size to the Patient Services Manager within thirty (30) days of receipt of the initial notification