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Reference Sources (8)FINANCIAL ASSISTANCE APPLICATION ... - Harris Health
security card, other federal documents showing identity and residency in Harris County, hospital or birth records, adoption papers or records, voter's registration ...
Source: https://www.harrishealth.org/SiteCollectionDocuments/eligibility/applicant-forms/English/application-instructions-english.pdf
Gold Card Application - HOMES Clinic
records, voter's registration card, current wage stubs, Medicare card or current ... child care provider, Harris County Hospital District Residence Verification Form ...
Source: http://www.homes-clinic.com/Documents/Gold%2520Card%2520Application.pdf
Houston, quiting could be as easy as 1, 2, 3. - Hispanic Health ...
FREE Tobacco cessation classes for adults with Gold Card. Please call .... To apply for a Harris County Hospital District Gold Card, call (713) 566-6509, or visit ...
Source: http://www.hispanic-health.org/Smoke%2520Free%2520Houston%2520Campaign%2520Flyer-FINAL%2520v8-24-10.pdf
English - Harris County Public Health and Environmental Services
Jul 31, 2012 ... Adults 16 years and up, who qualify for HCHD Gold Card. Call 713-643-3691 for Gold Card Eligibility. HCPHES DHP(713) 439-6171. 7/31/ ...
Source: http://www.hcphes.org/dccp/dental/DentalReferralSheetEng.pdf
Patient Statement - Harris County
Jun 29, 2011 ... The Financial Assistance Approval Notice will replace your gold card. • Please start the renewal process for your eligibility at least 30 days in advance. • If you are about to turn 65, you must apply for Medicare at least 90 days prior to ... These Co-Payments are for Harris County Hospital District charges only.
Source: http://www.pur.hctx.net/specs/2011/110198a%2520Attachment.pdf
Access to cancer care for low income and uninsured in harris county
You can download the form from the HCHD website: http://www.hchdonline.com/ patient/onecard/goldcard.htm. Complete the form and attach copies of all ...
Source: http://www.texascancer.info/access/access_harris.pdf
1906 Cochran Houston - HAY Center
Jun 25, 2010 ... Harris County Protective Services ( children and ... Harris County Gold Card Program …713-715-2800 .... Health Clinics: Apply for Gold. Card ...
Source: http://www.haycenter.org/20100625%2520HAY%2520%2520HELP%2520Guide.pdf
This Street Card is designed to give useful ... - City of Houston
GOLD CARD ELIGIBILITY Harris County. (713) 715-2800. Texas Homeless Education Department. 1 (800) 446-3142. TWC Tele-Serve – Unemployment.
Source: http://www.houstontx.gov/housing/pdf/helpcard.pdf
