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Deaconess Financial Assistance (Baptist Health Deaconess) fax number

(812) 450-5261

Financial Assistance

Used for: Submission and processing of the Financial Assistance Application for patients seeking charity care or cost relief.

Fax destination details

Department
Financial Assistance
Purpose
Submission and processing of the Financial Assistance Application for patients seeking charity care or cost relief.
Form
F-4513 Financial Assistance Application — Financial Assistance Application
Address
PO Box 3366, Evansville, IN 47732
Voice phone
812-450-3435

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Complete the Financial Assistance Application with required income/household information and supporting documentation, then submit to Deaconess Financial Assistance. Processing typically takes 10–14 days. For submission options: mail to PO Box 3366, Evansville, IN 47732; fax to 812-450-5261; or email Financial.Assistance@deaconess.com; for questions, call 812-450-3435.

Official form instructions are published as a downloadable file on the organization's website.

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