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Supporting documentation

The HCA Healthcare Hope Fund is required to obtain supporting documentation for every grant given because the Hope Fund is a 501(c)3 nonprofit organization and not an HCA Healthcare employee benefit

The forms of supporting documentation required for each situation are listed below. You can attach all supporting documentation to your online application, or you can email the documentation to hopefund@hcahealthcare.com or fax it to 866-337-4354. Please be sure your name and 3-4 ID are on the cover page. Note that the Hope Fund staff may ask for additional forms of documentation to verify your event and need.

Illness or injury

The Hope Fund can consider the financial needs related to an extended illness or injury for a colleague or their dependent spouse/children.

Illness or injury required documentation
  • Physician documentation stating the nature of the illness/injury and the dates the colleague or spouse is unable to work
  • If the spouse is out of work/unpaiddocumentation from spouse’s employer as to pay rate and unpaid status while out of work
  • Physician documentation stating need for treatment and amount that is due in advance of receiving treatment (if applicable)
  • Documentation for dates of treatment and expenses related to travelhotel fees, air/car travel, etc. (if applicable)
  • Outstanding/unpaid medical bills, after insurance payments and adjustments (if applicable)

Natural disaster

The Hope Fund can consider the financial needs related to a natural disaster that affects the colleague's primary residence.

Natural disaster required documentation
  • Copy of fire or insurance report
  • When fire or insurance report is not available, a letter from a landlord or estimate of repair costs from a verified contractor should be submitted
  • In situations of large scale disaster (such as hurricanes), you may apply for assistance with emergency needs first, and then follow-up documentation will be requested for long-term needs
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Family death event

The Hope Fund can consider the financial needs due to an unexpected death of a dependent family member or if travel assistance is needed due to death in the immediate family.

Family death event required documentation
  • Burial needs: itemized bill from funeral home which includes the deceased’s name, city and state of funeral home and amount to be paid by applicant or spouse
  • Travel needs:
    • Statement from the funeral home or newspaper clipping indicating the applicant’s relationship to the deceased
    • Documentation of travel expenses incurred

Domestic violence

The Hope Fund can consider the financial needs when a colleague or dependent family member is experiencing a domestic violence event.

Domestic violence required documentation
  • Copy of an active restraining order or an order of protection. In some situations, a letter from a professional (clergy, counselor, social worker, etc.) will be accepted in absence of a restraining order
  • Documentation of expenses such as rent, first/last security deposits for moving to a safe location or loss of income for mortgage/rent payments

Other special situations

The Hope Fund considers assistance with unexpected, qualifying events hindering the applicant from meeting their basic household needs.

Other situations required documentation
  • Past due rent or mortgage
  • Past due utilities
  • Signed lease and security deposit to move into a new residence
  • Utility deposit to connect basic utilities at a new residence

Car repairs

Assistance for major car repairs can be considered when repairs are needed to the applicant’s sole source of transportation for a condition that is preventing the applicant from using the vehicle with no alternatives to travel to work.

Car repair required documentation
  • Documentation from mechanic or dealership which details the major repairs needed and the cost of the repairs

COVID-19 event

Colleagues impacted by personal financial loss or impact due to COVID-19 may qualify for Hope Fund assistance.

COVID-19 event required documentation
  • Past due rent or mortgage
  • Past due utilities
  • Physician documentation stating the nature of the illness/injury and the dates the colleague or spouse is unable to work
  • Invoice, bill or receipt of expenses for additional childcare needs due to school/childcare closure