Accessing & Requesting Financial Assistance Information
Besides accessing information about our Financial Assistance Program on our website, you can also access it in the following ways:
- Request the information in writing by USPS mail or by visiting a Concord Hospital Financial Counselor at 250 Pleasant Street, Concord, NH 03301;
- Request the information directly by calling (603) 227-7101 or sending an email request to financialcounseling@crhc.org;
- Request a financial assistance application at any check-in or registration area at any of our locations.
How to Apply
- Complete a financial assistance application and submit it along with the following:
- Complete a copy of your most recent Federal Income Tax Return and all schedules. Include copies of last year's W-2 forms;
- Copies of the three most recent, paycheck stubs or a statement from the employer;
- Copy of your most recent bank statement (e.g., savings, checking, money market, IRA, 401K, etc.);
- Copies of unemployment, disability compensation benefits statements;
- Copies of social security or pension benefit income;
- Copy of food stamp allocation;
- Copies of government assistance notices (including the Department of Health & Human Services).
If you do not have all of these documents call (603) 227-7101 and speak with one of our financial counselors.
Decision & Notification
Every effort is made to finalize the decision after receipt of a complete application. Decisions are reviewed and approved by either a supervisor or a director. Notification of a decision is sent in writing.
Concord Hospital will not discriminate in the determination of financial assistance eligibility on the basis of race, color, ethnic origin, sexual orientation, marital status, creed, age, sex or disability.
Availability of Translations
Our financial assistance policy, application form and plain language summary can be offered in English and Spanish or any other language upon request. For more information, please call (603) 227-7101.