Financial Assistance Process

How to Apply for Financial Assistance

Step 1

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Get the Financial Assistance Policy Information

  • Online at samhealth.org/billing
  • By writing
    • Samaritan Health Services
    Regional Business Office
    PO Box 1188
    Corvallis, OR 97339-1188
  • By visiting
    • Patient Financial Services Center
    815 NW Ninth St
    Corvallis, OR 97330-9803
  • By calling 1-800-640-5339

Step 2

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Gather Supporting Documents Needed for Application

  • Payroll check stubs (last three months and most recent check stub showing gross year-to-date earnings), most recent IRS tax return or bank statement
  • If unemployed, bank statements, Federal tax return, statement of benefits or other unemployment compensation records
  • If on a government program, notice of benefits
  • School financial aid award letters and transcripts

Other documents may be required. Please check the Request for Financial Assistance Application for more details.

Step 3

Paper and Pen

Complete and Return Application

Complete and return the Application for Financial Assistance along with the required supporting documents within 10 days from receipt of your billing statement.

Confidential Lock

All information relating to the application will remain confidential. Additional information may be required.

Submit Application and Supporting Documents to:

Samaritan Health Services
Regional Business Office
PO Box 1188
Corvallis, or 97339-1188