Charity Care Application

It is the policy of Evans Memorial Hospital (EMH) to provide emergency care to all patients reguardless of their ability to pay.  EMH shall allocate resources to identify charity cases and provide uncompensated care based upon the information submitted at the time of application for charity care by the patient or their representative or through the use of other criteria-based methods to determine eligibility.

Application Instructions - English

Charity Care Application Form English

Charity Care Application and Instructions - Spanish

Financial Assistance Summary

Evans Memorial Hospital's Charity Care Policy