Financial Assistance Program - Plain Language Summary

JPS Health Network offers Financial Assistance to eligible individuals. We serve the emergency health care needs of all patients, regardless of ability to pay. You can obtain an application and additional information regarding our Financial Assistance from any of the sources below:

  • Phone an Eligibility & Enrollment specialist at (817) 702-1001 between the hours of 8:00 a.m. and 5:00p.m.
  • Download and complete the application from JPS Health Network website at  
  • Write or visit Eligibility & Enrollment Department at 1325 S. Main Street, Fort Worth, TX 76104.

Determination of eligibility for the Financial Assistance Program is made based on review of a completed application, minimum requirements for assistance: Tarrant County Resident, US Citizen or Legal Permanent Resident, meet income guidelines and not be eligible for any State or Federal funded program.

The Financial Assistance Program applies to all JPS Health Network locations, assistance might also be available for prior visits.

Patients and families will not be charged more for Emergency or other medically necessary care than Amounts Generally Billed (AGB) to those patients who have insurance.

Financial Assistance forms or applications are available in Eligibility Department, Registration areas, and in the Emergency Department. Translation services/arrangements are available upon request.

Thank you for choosing JPS Health Network for your health care needs.

Financial Assistance Policy (.rtf)

Financial Assistance Procedure (.rtf)