Waive

CALHOUN-LIBERTY HOSPITAL

BLOUNTSTOWN, FL · version 1 · published · JSON

eligibility.free_care_max_fpl100% of the federal poverty level

"Patients whose family income is in the range of 0-100% of the Annual FPG are eligible to receive a discount of 100%."

documented · checked 2026-10-10 · SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT

apply.documents_requiredTax return
Bank statements

"Include an application process, in which the patient, the patient’s guarantor or supporting person/persons are required to cooperate and supply personal, financial and other information and documentation relevant to making a determination of financial need (such as but not limited to tax returns, bank statements, proof of assets etc.)."

documented · checked 2026-10-10 · 1 Policy and/or Procedure: Financial Assistance ...

apply.submit_methodsMail: Physical/Mailing Address: Calhoun-Liberty Hospital 20370 NE Burns Avenue Blountstown, FL 32424
Fax: Fax: 850-237-3011
In person: Visiting our Business Office which is open Monday through Friday from 8:00am to 4:30pm CST

"How to Apply for Financial Assistance: To apply for financial assistance, please submit a complete Financial Assistance Application with the required supporting documents to the address or fax below. Physical/Mailing Address: Fax: Calhoun-Liberty Hospital 850-237-3011 Attention: Financial Counselor 20370 NE Burns Avenue Blountstown, FL 32424"

documented · checked 2026-10-10 · SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT

contacts.phone850-237-3025

"Calling 850-237-3025"

documented · checked 2026-10-10 · SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT

contacts.hoursMonday through Friday from 8:00am to 4:30pm CST

"Visiting our Business Office which is open Monday through Friday from 8:00am to 4:30pm CST"

documented · checked 2026-10-10 · SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT

Sources

SUBJECT: FINANCIAL ASSISTANCE PAGE: 1 DEPARTMENT — fetched 2026-10-10

1 Policy and/or Procedure: Financial Assistance ... — fetched 2026-10-10