Sisters of Mercy Urgent Care strives to provide high-quality, affordable healthcare to everyone in the communities we serve. As part of this mission, we've established the Compassionate Care Program to assist those who may not have enough money to pay for services. Applying for the Compassionate Care Program is easy:
- Complete the PDF application below and bring it and any supporting documents to any Sisters of Mercy Urgent Care location at the time of your service. If you are unable to print the documents, you may pick up an application at any Sisters of Mercy Urgent Care center.
- Click here to download the application in English. (You'll need the free Adobe Reader to open this file. Download it here.)
- Haga clic aquí para descargar la solicitud en español. (Necesitará el gratis Adobe Reader para leerlo. Descárguelo aquí.)
- You'll pay a nominal fee of $10, $25 or $35 - based on income level - at the time of service.
- After reviewing your Compassionate Care application and supporting documents, we'll determine the percentage of your bill covered by the program and notify you of your remaining balance, which may be paid by cash, check, credit card or debit card.
Compassionate Care Application Guidelines
- Income information must be provided for all income-producing family members in the immediate household.
- Please provide proof of income using W2 forms, tax returns or current payroll stubs.
- Submitting an application does not guarantee that assistance will be granted.
- Submit a separate application for financial aid for each new visit. Approval for one visit does not guarantee aid for future visits.
Questions? The Sisters of Mercy staff is happy to answer any questions you may have about the Compassionate Care Program. We may also be able to refer you to other agencies that provide financial assistance for healthcare. Please call us at (828) 252-8957, Option 7.