Riverside University Health System Medical Center (RUHS-MC) fax number

Fax destination details

Department

Charity Care/Financial Assistance (Medically Indigent Services Program, MISP)

Purpose

Application submission for charity care and financial assistance

Form

Application for Charity Care and Financial Assistance — Application for Charity Care and Financial Assistance (MISP)

Address

26520 Cactus Avenue, Moreno Valley, CA 92555

Voice phone

877-501-5085

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.

Submit the completed, signed application along with a copy of photo identification and proof of current family income (or a statement of support if there is no income). Include any required supporting documents. Processing may take about 30 days. This form applies to Riverside University Health System Medical Center Charity Care and Financial Assistance.

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