Apply

Complete an application for hospital debt relief

Apply Here
Resources

Need help? Access support materials here

View Resources
Search for Your Hospital

Find a hospital in your area using the search tool.

Find a Hospital

Are you curious if you might qualify for Debt Dismissal?

60% of Americans Are Eligible for Medical Debt Relief.

Ready to apply? Watch how easy it is here!

We walk you through every step of the process, so you know exactly what to expect.

Application Checklist

Please have a copy of the following items prior to begining your online application

  • Debt Dismissal Employer Code
  • Pay Stubs from the Last to Months
  • Bank Statements from the Last Two Months
  • Last Year’s W2
  • Last Year’s Tax Return
  • Health Insurance Cards, if Applicable
Application Checklist