Click on the links below to view and print copies of the Emory Helthcare Financial Assistance Policy, Plain Language Summary and Financial Assistance Application Form. These documents are available in English or Spanish.

Please review the U.S. Federal poverty guidelines which is used to determine financial eligibility for certain federal programs.

English

Emory Healthcare Financial Assistance Policy

Plain Language Summary

Financial Assistance Application Form (Financial Statement Profile)

Spanish

Emory Healthcare Financial Assistance Policy

Plain Language Summary

Financial Assistance Application Form (Financial Statement Profile)

Emory Provider List (pdf)

Patients and Visitors