Financial Assistance Criteria

Click here for Financial Assistance Criteria

Click here for Financial Assistance Policy

Click here to download the Financial Assistance Application Forms

Click here for Financial Assistance and Uninsured Discount Policy Statement

  • Please print these forms and fill them out completely.
  • Bring the forms to Princeton Community Hospital’s Patient Support Services Department or you can mail them to Princeton Community Hospital, Patient Support Services, P.O. Box 1369, Princeton, WV 24740 or bring the forms to BRMC Financial Counselors.
  • If you need assistance, call: 304-325-1912 or 304-327-1632
  • In order to apply for a Medicaid card, the patient will need a record of household income for the past three months along with their most recent bank statement.