Financial Assistance Criteria

Please print these forms and fill them out completely.

Bring the forms to Princeton Community Hospital’s Patient Support Services Department or mail them to:

Princeton Community Hospital
Patient Support Services
P.O. Box 1369
Princeton, WV 24740

If you need assistance, call 304-487-7566.

In order to apply for a Medicaid card, the patient will need a record of household income for the past three months along with their most recent bank statement.