Charity Care Program
Sutter Regional Medical Foundation

Sutter Regional Medical Foundation offers financial assistance to patients who are uninsured or have a low income, and may have difficulty paying bills. Patients who submit applications and are approved may be eligible for full or partial relief from charges.

SRMF's Charity Care Program is designed to:

• Provide charity care to uninsured patients earning up to 200 percent of the Federal Poverty Income Guideline (FPIG). The FPIG is updated each year in February and can be viewed by clicking here.
  
• Provide catastrophic protection to low income uninsured patients by limiting their liability to 30 percent of their annual household income.

To apply for charity care at SRMF, please complete the Charity Care Application, and include the following:

• Your two most recent paycheck stubs
  
• Your two most recent bank statements (all accounts)
  
• Your most recent tax return

Send the completed packet to:

Patient Financial Representative
Sutter Regional Medical Foundation
2720 Low Court
Fairfield, CA 94534

Copies of SRMF’s Charity Care Application are also available by calling 1-866-233-5330 between the hours of 8 a.m. and 5 p.m.

Your Confidentiality is Guaranteed
Confidentiality of information and individual dignity will be maintained for anyone who seeks charitable services. The handling of personal health information will meet all HIPAA requirements.