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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/unpaid—documentation 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 travel—hotel 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

Family Death

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 required documentation

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

Essential Needs

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

Essential needs documentation

Documentation of the event that has led to your financial need
Notice to vacate/foreclosure notice
Separation letter from previous employer that clearly states the reason and date for unemployment on company letterhead with contact information
Notice of condemnation/other documentation showing home uninhabitable
Signed lease and/or landlord statement for new rental property stating all finances needed to move in (security deposit, first month's rent, etc.)
Essential utilities deposit statements (electricity, gas, water)
Any other documentation relevant to this request (insurance report, etc.)

Major 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.

Major car repairs required documentation

Apply for help

Supporting documentation

Illness or Injury

Natural Disaster

Family Death

Domestic Violence

Essential Needs

Major Car Repairs

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