|Financial Assistance Program|
As part of Mendota Community Hospital's Mission statement, we will work for the health and well being of the citizens of the area and will provide care to patients who are uninsured or underinsured and do not have adequate financial resources to pay for necessary healthcare services provided by the hospital.
Financial Assistance includes:
To get an application, click the link to open it and print.
If additional room is necessary, submit an attachment page or write in margins.
Once filled out and signed, the application may either be faxed to the attention of:
OR mailed to: