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Methodist Le Bonheur Healthcare fax number
(901) 266-6474
Self Pay Department
Used for: Submit Financial Assistance Application (Level One/Level Two Medical Financial Assistance) and supporting income documents by mail, fax, or email; the Return To address and fax number are provided on the application.
Fax destination details
- Department
- Self Pay Department
- Purpose
- Submit Financial Assistance Application (Level One/Level Two Medical Financial Assistance) and supporting income documents by mail, fax, or email; the Return To address and fax number are provided on the application.
- Form
- Financial Assistance Application — Application for Financial Assistance
- Address
- P.O. Box 172193, Memphis, TN 38187-2193
- Voice phone
- (901) 842-1255
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Complete the application with the requested household and income information, attach proof of income (e.g., 1040 tax return or alternative documents), and return to Methodist Le Bonheur Healthcare – Self Pay Department.
Official form instructions are published as a downloadable file on the organization's website.
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