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Thank you for your continued involvement and support of the Health
Access Project. Below are a few resources to aid you in your work
with HAP.
Enrolling an existing patient in HAP
If you are currently providing charity care for a low-income,
uninsured patient who you feel would benefit from HAP services,
please
download an enrollment form then fax it to us. If the patient meets
HAP eligibility requirements, we will enroll them in the Health
Access Project.
HAP
Patient Enrollment Form (Referral Form)
(provided in Adobe Acrobat Format).
Please help us track the value of services donated
To enable HAP to track the amount of charity care performed by
volunteer providers, please submit completed HCFA 1500 forms
using your standard billing rates to:
Health Access Project
140 West 2100 South, Suite 208
Salt Lake City, UT 84115
Fax: 412-3997
Additional resources for caring for non-English speaking patients
Translated
Hospital Instructions
Translated Patient
Education Materials
Translated Community Resource
Lists
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