Financial Assistance
Sliding Fee Discount
No patient will be turned away because of an inability to pay
ApplicationTo apply fill, out the Patient Financial Screening Form below:
How will my discount be determined?After completing the Patient Financial Screening Form, your total monthly gross income and the number of people you are financially responsible for in your household, will be used to determine the level of discount that you and your family are eligible to receive.
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Proof of IncomeRCMS staff is available to assist patients in determining if they are eligible for our Sliding Fee Options. Applicant must provide proof of income within 30 days for slide to be effective for one year otherwise it will expire. You can reapply as needed. Examples of proof of income include:
If you are unable to provide RCMS with one of the approved forms of income documentation, please call 707-882-2189 for assistance.
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