Financial Assistance Program 


It is the policy of INTEGRIS Health to screen and treat all patients without regard to race, color, national origin, age, gender, religion or source of payment for care. If you feel you do not have the financial resources to pay for your care, you may qualify for the INTEGRIS Health Financial Assistance Program. Financial assistance is based on your annual income, family size and the amount of debt that you owe. You will be required to complete a financial statement and to provide supporting documents so that your eligibility for financial assistance can be determined.


To download a copy of the forms for financial assistance consideration you will need Adobe Reader. To download a free version of Adobe Reader, please click on the button below:



Upon completion of the forms and required documents please mail the information to:

INTEGRIS Health Central Business Office
3100 Quail Springs Parkway, Suite 101
Oklahoma City, OK 73134


If you have additional questions please contact our Customer Service Department, Monday through Friday between the hours of 7:30AM and 5:00PM. Our phone number for the Oklahoma City area is 405 252 8400 and all other areas; toll free 1-(855)-409-5458.