CAPITAL HEALTH MEDICAL CENTER - HOPEWELL

"* Family Income at 0 to 200% of FPG Full Financial Assistance; $0 is billable to the patient."

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"[Click here](https://www.capitalhealth.org/sites/default/files/2018-04/FAP%20Form%20from%20FI%20006%20Charity%20Care%20Policy%20Jan%202016%20-%20FINAL.pdf)to download/print Capital Health's Financial Assistance Application Form."

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"1. Form of Identification (i.e. Driver's License, State/County ID, S.S. Card, Birth Certificate, Passport, Visa, Alien Registration Card, Employee ID card, Student ID, or Union Membership Card). 2. Proof of New Jersey Residency for or prior to the date of service (i.e. Utility Bill, Phone Bill, Copy of Deed or Lease, any of the above forms of ID with the address and an effective date which compares to the application date, mail received with the applicants name and current address and an attestation that the patient resides in NJ since the date of service or a letter from the landlord, roommate or other NJ resident with whom the applicant is living stating the NJ address). 3. Income Information prior to the Date of Service (i.e. paystubs, employer letter, Benefit Statement for Unemployment, Disability or Social Security, Letter from Employer on Company letterhead stating exact income for applicable time period, Income Tax returns or a signed statement of no income and a letter of support). 4. Asset Information as of the Date of Service (i.e. Bank Statement for Checking or Savings Account, Other Bank Accounts, IRAs, 401ks, CDs or other Stocks, Bonds or Negotiable Paper)."

documented · checked 2026-10-10 · Charity Care Fact Sheet (English)

"**How to Apply** – FAP and the related Application Form may be obtained/completed/submitted as follows: 1. Obtained at Capital Health’s main Outpatient Registration desk. 2. Request documents be mailed to you, by calling Capital Health’s Patient Accounts Department at 609-394-6023. 3. Download the documents from the Capital Health website 4. Mail completed applications (with all documentation/information specified in the application instructions) to: Capital Health Patient Accounts Department, 750 Brunswick Avenue, Trenton, NJ 08638"

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"For help, assistance or questions, please call the Capital Health Patient Accounts Department at 609-394-6023."

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"If you would like to schedule an appointment or if you have any questions, please call 609-362-2200 for all Capital Health Locations listed below. Capital Health Regional Medical Center Capital Health Medical Center -Hopewell Capital Health Family Health Center Capital Health at Deborah – Emergency Services Capital Health East Trenton"

documented · checked 2026-10-10 · Charity Care Fact Sheet (English)