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Get Ballad Health Application For Financial Assistance 2019-2024

At applies. Sign and return to the address listed below. Documentation should include all family members in the household. *Attach the parent s income information if the patient is a full-time student and claimed on their parent s tax returns. Required Documentation (*DO NOT send originals* Please use black ink) If you are employed, you will need to provide your W-2 and your last 3 month s pay stubs. If a W-2 and pay stubs are not available, you will need a letter from your employer o.

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