To write a letter requesting help with hospital bills, start with a polite greeting and introduce yourself, mentioning your situation briefly. The document provides two sample request letters asking for financial assistance to pay hospital bills.Patient Information. If you would like to apply for financial assistance, please complete our financial assistance form. Financial Assistance Form or Download. Enclosed is a copy of my completed application for financial assistance. Please note that the financial assistance application form and the letter of support both require official signatures. With our financial assistance, you will be able to receive the Parkview care you expect – no matter what medical obstacles you might face. Get free legal advice and find a free or lowcost lawyer. Can I request an excuse from service due to a financial or medical hardship?