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, including Fort Sanders Regional Medical Center, 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, Fort Sanders Regional Medical Center 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 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

A financial counselor may also be able to assist you with these matters. At Fort Sanders Regional Medical Center, financial counselors are available from 8 a.m. to 4 p.m. Monday through Friday. You can reach a counselor by calling (865) 331-1112.