Thank you for choosing Southeast Alabama Medical Center for your healthcare needs. If you do not have health insurance or the ability to pay your bill, we may be able to help through our financial assistance program. Southeast Alabama Medical Center provides financial assistance in the form of discounts to patients based on their income, assets, and needs.

Please help us assist you by completing the financial application and return it to our Patient Accounts Department located on the 1st floor of our main patient tower just inside the Discharge Entrance.  A link to a printable form of the financial application is provided on this page.

Download Financial Application

In addition to the financial application please return with the following items:

• Proof of total household income by submitting a copy of your last years W-2 tax forms or a letter from your employer with your year to date income.
• If there is no income within the household, please explain in detail how your monthly household expenses are paid.
• Include a copy of your latest utility bill.

If you choose to mail your information you may do so to the following address:

Southeast Alabama Medical Center
Patient Accounts Department
P.O. Drawer 6987
Dothan, AL. 36202

Please return all requested information within 30 days of your discharge for review or the outstanding account will return to the normal collection process and can no longer be considered for any form of assistance. We will be in contact with you after the requested information has been received and reviewed, so please ensure that your telephone and address is correct.

If you have any questions regarding the information requested, please feel free to contact

Patient Accounts Department
Monday through Friday from 8:00am to 5:00pm
(334) 793-8711 or 800-592-5384.