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How to use or fill out Application for Financial Assistance - Children's Hospitals and Clinics with our platform
- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the 'Where have you received care?' section. Check all applicable locations to ensure accurate processing.
- In the 'Minnesota Healthcare Programs' section, indicate if you have applied for Medical Assistance or MinnesotaCare by selecting 'Yes' or 'No'.
- Complete the 'Applicant' section with your personal details, including name, date of birth, address, and contact information. Ensure accuracy as this information is crucial.
- Provide income verification details in the 'Monthly Income and Assets' section. List all sources of income and attach proof as required.
- Fill out the 'Authorization(s)' section by signing and dating where indicated. This confirms that your information is accurate and allows for necessary verifications.
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