Gold card application 2026

1. Click ‘Get Form’ to open the gold card application in the editor.
2. Begin by entering your personal information in the designated fields, including your name, maiden name, home address, and contact numbers. Ensure all details are accurate.
3. Indicate your marital status by selecting the appropriate option. If applicable, provide information about any previous visits to Ben Taub, LBJ, or Quentin Mease Hospitals.
4. List all household members by filling in their last names, first names, dates of birth, social security numbers, and relationships to you. This section is crucial for assessing eligibility.
5. Document your household income by detailing sources of income for each member. Include amounts and frequency of payment to provide a complete financial picture.
6. Finally, review all entered information for accuracy before signing the form electronically. Your signature certifies that the information provided is true and complete.

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