Financial Assistance Memorial has an eligibility team that will help you find out which programs you qualify for. If you have any questions about these programs, please call us at 954-276-5760. We are available from 8:30 am until 4:30 pm, Monday through Friday. You can set up an appointment to come meet with a member of our eligibility team. You will need to bring with you the following documents: A financial evaluation form which you should print and fill out. This form must be signed in the presence of an eligibility team member Past three months of bank statements Current Utility bill Florida Driver License/photo identification Employer wage stubs for three months Income Tax Return The eligibility team will confirm your current income level to see if you qualify for any federal or state programs during your appointment. If you do not qualify for any federal or state programs, we will research which assistance program you qualify for. The assistance programs are based on the current Federal Poverty Guidelines and offer a sliding scale of assistance for any uninsured or underinsured patient that has an annual family income that is less than 400% of the Federal Poverty Guideline. Assets (excluding your primary home and your primary vehicle) are considered a part of your annual income. If you are a resident of South Broward and are uninsured, we recommend that you call South Broward Community Health Services to see if you qualify for these services. Please call 954-276-5500 to set up an appointment.