Patient financial assistance
Dear patient,
At Acutis, patient care is our number one priority.
We do understand that laboratory testing, while medically necessary, may cause a patient’s unnecessary financial burden. In accordance with state and federal laws, Acutis offers a Financial Assistance program to those who qualify.
In order to determine if you qualify for the program, we request that you complete the Financial Disclosure application form and provide the requested documents listed below:
• A copy of the most recent pay stub (s)
• A copy of the previous year’s tax return
• Verification of unemployment
• A proof source indicating that you are eligible for local, state, or federal assistance programs
We will review your application and documentation to determine if you qualify for the program. Upon determination, you will receive a notification letter whether you qualify.
​
Thank you for being an Acutis patient!