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Patient Financial Assistance Program Documents

Program Policy

Plain Language Summary

Program Application

Amounts Generally Billed

The following documents related to our policy and eligibility have been translated into many languages for your convenience.

Language Policy Plain
Language Summary
Application Amounts Generally Billed
English View View View View
Arabic View View View View
Armenian View View View View
Chinese (Simplified) View View View View
Chinese (Traditional) View View View View
Czech View View View View
Farsi View View View View
French View View View View
German View View View View
Greek View View View View
Gujarati View View View View
Hebrew  View View View View
Hindi View View View View
Hmong View View View View
Hungarian View View View View
Italian View View View View
Japanese View View View View
Korean View View View View
Polish View View View View
Portuguese (Brazilian) View View View View
Russian View View View View
Serbian View View View View
Spanish (Latin) View View View View
Tagalog View View View View
Thai View View View View
Ukrainian View View View View
Urdu View View View View
Vietnamese View View View View
Yiddish View View View View

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Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email [email protected].

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