Financial Assistance Process

Get the Financial Assistance Policy Information

• Online: samhealth.org/billing
• By writing: Samaritan Health Services, Regional Business Office, PO Box 1188, Corvallis, OR 97339-1188.
• By visiting: Patient Financial Services Center, 815 NW Ninth St., Corvallis, OR 97330-9803.
• By calling: 1-800-640-5339

Gather Supporting Documents Needed for Application

• Payroll check stubs (last three months and most recent check stub showing gross year-to-date earnings), most recent IRS tax return or bank statement
• If unemployed, bank statements, Federal tax return, statement of benefits or other unemployment compensation records
• If on a government program, notice of benefits
• School financial aid award letters and transcripts

Other documents may be required. Please check the Request for Financial Assistance Application for more details.

Complete and Return Application

Complete and return the Application for Financial Assistance along with the required supporting documents within 10 days from receipt of your billing statement.

All information relating to the application will remain confidential. Additional information may be required.