Baum Harmon Mercy Hospital is pleased to offer financial assistance to our patients. Please complete this financial statement and return it along with the list of supporting documentation. Please send copies of all documentation.
The following documentation is needed to process the application;
NO APPLICATION WILL BE CONSIDERED WITHOUT DOCUMENTATION.
Financial Assistance Application(español)
Financial Assistance and Charity Care Policy(Plain Language)
Please return completed application and documentation to:
PO Box 528
Primghar, IA 51245
For assistance please call: 712-957-2300