Goshen Hospital & Goshen Surgery Center financial assistance

Application for financial assistance. Please print, fill out and mail or fax your completed application to the address below for review and consideration.

Goshen Hospital Application

Additional information regarding financial assistance

• Summary of financial assistance
• Financial assistance policy

Mail or fax your application to:

Goshen Hospital
Attn: Financial Advocate
200 High Park Avenue
Goshen, IN 46526

Phone: (574) 364-2607
Fax: (574) 364-2436

Goshen Surgery Center also offers financial assistance through Carecredit.com using either of the following options:

• Apply for Care Credit online 
• Call (800) 365-8295

For questions regarding Goshen Surgery Center financial assistance or in-house payment agreements, please call (574) 364-4736 or (574) 364-4734.


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