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NYU Langone Health Faculty Group Practice fax number
(646) 754-7566
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Faculty Group Practice
Used for: Financial assistance application submission
Fax destination details
- Department
- Faculty Group Practice
- Purpose
- Financial assistance application submission
- Form
- Financial Assistance Application — Financial Assistance Application
- Voice phone
- 877-648-2964
- Website
- Visit organization website
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All sections must be completed. Submit the application with supporting documents. Process reviewed against Federal Poverty Level. Must be submitted within 14 business days. Required documents include: most recent 1040 tax return with household size; copies of the most recent pay stubs (2 if biweekly, 4 if weekly); W-2 and/or 1099 forms if self-employed; unemployment documentation with full name and weekly benefit amount; notarized unemployment letter; termination letter if applicable; current school transcript for full-time students; retirement income documentation; and Social Security Benefit Verification Letter.
Official form instructions are published as a downloadable file on the organization's website.
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