Covenant Health is committed to providing quality health services in a caring environment. It is the expressed philosophy of Covenant Health and its member hospitals, that no one should be denied necessary medical care because of the inability to pay.

In conjunction with this philosophy, if you are an uninsured person with no public or private source of payment for medical services, Covenant Health will provide, at a reduced rate, medically indicated services.

To apply for financial assistance, please click the link in the right-hand column for the desired application form in either English or Spanish, print it, and completely fill out the information. The form also asks for supporting documentation as follows:

  • A complete copy of your most recent Income Tax Return and supporting W-2s
  • Two (2) current paycheck stubs from adult members of the household
  • If disabled or retired, send verification of current monthly Social Security and/or retirement benefits (e.g., letter from Social Security or current bank statement).
  • If receiving Food Stamps, send verification of benefits.
  • If you are not employed, you must provide a dated, notarized letter from the person(s) providing help with living expenses.
  • Do not send any bills – only the application and proof of income as listed above.

Thank you in advance for including the required information. Mail the completed financial assistance form and supporting documentation to:

Covenant Health 
Attn: Charity Department 
1420 Centerpoint Blvd. 
Knoxville, TN 37932

If you have additional questions, please call (865) 970-9800 Monday through Friday between 8 a.m. and 5 p.m.