Financial Assistance Process

Get the Financial Assistance Policy Information

• Go online to: Samaritan Financial Assistance Policy.
• Write to: Samaritan Health Services, Regional Business Office,
        PO Box 1188, Corvallis, OR 97339-1188.
• Call: 800-640-5339

Gather Supporting Documents Needed for Application

• Payroll check stubs (past 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 the Application

Return the completed Financial Assistance Application along with required supporting documents within 10 days from receipt of your billing statement.

All information related to the application remains confidential. Additional information may be required.