Patient Financial Assistance

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PATIENTS & VISITORS

Patient Financial Assistance

Please click the link below to download our Patient Financial Assistance Form. After filling out the application please either return it in person to 1616 S Pioneer Way, Moses Lake.

Fax it back to 509.764.3244

Email it back to FinancialCounselor@SamaritanHealthcare.com

Or Mail It:
660 S. Coolidge Street
ATTN: Patient Financial Services
Moses Lake, WA 98837

If you have any questions regarding this form, please call 509.793.9715.

Financial Assistance Policies
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