Contact Dollar For :: DollarFor

What do you need to know more about?

Have you already contacted Dollar For about this bill?

Who is billing you?

Dollar For may be able to help you apply for hospital bill forgiveness. Please select your hospital.

Hospital State *

Hospital City *

Hospital Name *

Check if you qualify for financial assistance

Doctors and others who work at hospitals sometimes bill patients separately.

Unfortunately, most financial assistance policies only apply to the hospital bills. Most other providers will not automatically forgive your bills.

Start by getting financial assistance approval from the hospital. Then, show the approval letter to your other providers and ask them to honor the decision.

Check If You Qualify for financial assistance

Please share your contact information and details about the hospital where you were treated.

We’ll research that location and be in touch soon!

First Name *

Last Name *

Email Address *

Hospital Name *

Hospital Street Address *

Hospital City *

Hospital State *

Hospital Website

Anything else we should know? *

Unfortunately, Dollar For can only help with hospital bills.

We cannot help with dental, ambulance, doctor co-pays, pharmaceutical, or any other medical bills.

Learn other ways to lower medical bills

First Name *

Last Name *

The Email Address you provided when you filled out the patient form *

Hospital State *

Hospital City *

Hospital Name *

How can we help you? *

Thanks for contacting Dollar For.

We will be in touch with you soon.

Thanks for your interest in partnering with Dollar For.

Please describe your organization. *

Nonprofit, faith, or community group Government Agency For-profit company

Tell us about your company

Organization Name *

City *

State *

Primary Contact First Name *

Primary Contact Last Name *

Email Address *?

Job Title *

Briefly tell us about the community you serve. *

How many people do you anticipate referring to Dollar For each month? *

Fewer than 50 50 – 100 100 +

We will create a custom URL to track your referrals. For example, dollarfor.org/cats.

Please select a short word or phrase (i.e. "cats") for your link.

Desired short phrase

Great! One final step!

By clicking submit below, you consent to the following agreement:

Dollar For grants you a non-transferable, non-exclusive, worldwide license to use our outreach materials for the sole purpose of promoting Dollar For services. The approval and grant of license may be revoked by Dollar For at any time at its sole discretion.
You understand that Dollar For does not and cannot guarantee that it will process a financial assistance application on a patient’s behalf or reduce their medical bill.

We are so happy to work with you to crush medical bills. Look for an email with guidance on how to get started.

Learn how you can educate your community about hospital bill forgiveness programs here.

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Dollar For does not currently partner with employers, health insurers, brokers, benefits coordinators, health share ministries, or other coverage-focused companies.

However, we will always help any patient struggling with hospital bills. Refer patients to us anytime at dollarfor.org/help.

What do you need to know more about?

Have you already contacted Dollar For about this bill?

Who is billing you?

Thanks for contacting Dollar For.

We are sorry.

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