Charity Care Application

To see if our Ohio Valley Cares Program can help you, please review the Charity Care Letter below. It lists the information you need to complete your Charity Care Application.

Once you have gathered the necessary information, please print and fill out the Charity Care Application below. In order to be considered for full assistance, please complete the application, sign the bottom, supply all requested documentation and return it to us within 14 days of receipt. All information is kept private and is used solely to process your application for the Ohio Valley Cares Program.

Our Charity Care Application is a PDF form you may print, fill out, and mail to us at:

Ohio Valley Hospital
Attention: Financial Counselor
25 Heckel Road
Kennedy Township, PA 15136

Please allow 10 business days for our review process. We will notify you of our determination by letter.

If you require further assistance, please call our financial counselors at 412-777-6130 or 412-777-6150.

Nuestra solicitud de cuidado de caridad está disponible en Español abajo.