Forms for Patients

Information and paperwork for financial assistance applications for the hospitals we work with most frequently are found in the links below. As of January 1, 2025, the application is the same for both. To obtain these documents in Spanish, scroll down to the very bottom of the English page where it is located, past the list of medical providers they share. There you will find the necessary forms and information in Spanish (and other languages).

Financial Assistance Application for:

Porter Hospital
Porter Hospital
University of VT Medical Center
University of VT Medical Center