Applications for Financial Assistance

Applications for Financial Assistance are available at Norwalk Hospital in the following locations:

  • Norwalk Hospital Trefz Lobby
  • Registration Department
  • Emergency Department
  • Office of Community Relations

Applications are available in English, Spanish, and Portuguese.

Norwalk Hospital will make a determination on your eligibility for financial assistance as soon as possible after receiving a completed application for assistance. You will receive written notice of the outcome of your case. In the event your application is rejected, we will provide you with the reason for the rejection and provide you with information on how to appeal the determination.

In the event you choose to appeal, we will work with you to ensure we take into account all relevant facts when making our final determination. If your application is accepted, you will not need to complete other applications for financial assistance until six months following our initial determination.