The completion of this application will help us determine eligibility for assistance towards your hospital bills. The document provides two sample request letters asking for financial assistance to pay hospital bills.Enclosed is a copy of my completed application for financial assistance. We have developed several financial assistance programs and resources to provide our patients with as much information and assistance as possible. Learn how to write a compelling hardship letter for medical bills with our step-by-step guide. Includes ChatGPT prompt. To fill out the Letter of Support form. Paperwork might be bank statements, income tax forms, check stubs, or other information. We may ask you to fill out a financial assistance application. 1. The following opening statement: Important: YOU MAY BE ABLE TO RECEIVE FREE OR DISCOUNTED CARE: Completing this application will help.