COVID-19 Vaccine Updates
As of May 12, 2021, everyone in Washington state age 12 and over is eligible to get the COVID-19 vaccine. Please visit our vaccine page for information on how to schedule an appointment.
Financial Assistance Forms
Get the Financial Assistance Forms You Need
Our Financial Assistance Application and Proof of Income instruction sheet are available to download in several languages.
Financial Assistance Application:
English
Arabic
Burmese
Chinese-Simplified
Chinese-Traditional
French
German
Italian
Khmer
Korean
Lao
Marshallese
Punjabi
Russian
Somali
Spanish
Tagalog
Ukrainian
Vietnamese
Proof of Income Instruction Sheet:
English
Arabic
Burmese
Chinese-Simplified
Chinese-Traditional
French
German
Italian
Khmer
Korean
Lao
Marshallese
Punjabi
Russian
Somali
Spanish
Tagalog
Ukrainian
Vietnamese
*Please submit completed financial assistance application forms using ONE of the following methods:
- Mail to:
PO BOX 5299
Mail Stop: 1002-1-PFN
Tacoma, WA 98415-0299 - Fax to: 253-864-4017
- Take a printed copy of your completed Financial Assistance Application to any of our main hospitals or medical centers' Admitting Desk, where a navigator will help you file it.
