Financial Assistance "*" indicates required fields X/TwitterThis field is for validation purposes and should be left unchanged.Thanks for using our Eligibility Checker for Financial Assistance! Please answer the following questions to see if you may be eligible for a discount on your Blanchard Valley Health System bills.Including yourself, how many people are in your immediate family?*“Family” is defined as the responsible party, the responsible party’s spouse (if applicable), and all of their natural or adoptive children under 18 who live in their home.Please enter a number from 1 to 10.What is your estimated gross MONTHLY household income?*This is current household monthly income before taxes.Please enter a number from 0 to 1000000.Phone # For Text (Optional)Family AdditionalsFamily Additional Total 5680Yearly Rate 15960Calculated % FPLAnnual Income
