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Get Augusta Health Application for Financial Assistance

Ed to outside agencies for collection, or those pending legal action, will not be considered eligible for financial assistance. If you think you may be eligible for financial assistance, you may complete the form (on back of this sheet), and submit it to the Business Office of Augusta Health. Augusta Health will make a written determination of your eligibility for FINANCIAL ASSISTANCE within 20 working days of your application. Complete the back of this sheet and mail application to: AUGUSTA HEA.

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