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Get Promedica Financial Assistance Application 2014-2024

family income as indicated below. Proof of your income should also be provided. Types of proof include wage verification (pay stubs 1 year prior to the date of service you are requesting assistance for), unemployment information, Social Security award letters, self-employment records, disability or worker’s compensation, alimony, child support, pensions, income tax returns, etc. If you have questions, please contact us at 800-477-4035. Please note all information provided is confidential and .

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