Written by a parent, not a doctor. Nothing here is medical advice.

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Children's Healthcare of Atlanta

Financial Assistance Program

What you get

Full or partial discounts on emergency and medically necessary hospital charges. This does not pay your household bills. Open now.

Who starts it
You
How it’s sent
Email to financialassistanceapplications@choa.org, or by post
Your time
An hour or so
Last checked
Aug 27, 2026

Before you start, check you fit

  • Your child is 21 or under.
  • You need at least $500 left to pay after insurance and other payments.
  • Discounts use an income scale up to 600% of the federal poverty level, or 400% for Hughes Spalding.

  1. What their form asksA preview, so you can gather things first. Fill it in on their site.

    Open the application PDF ↗ Checked Aug 27, 2026

    Send it by email to financialassistanceapplications@choa.org.

    What the form asks for

    Patient and account information
    Guarantor NumberPatient Name(s)Date of BirthMedical Record NumberMost Recent Date of Service
    Applicant and spouse or co-applicant
    Applicant — TitleApplicant — NameApplicant — Street AddressApplicant — City, State ZIPApplicant — Marital StatusApplicant — Home PhoneApplicant — Mobile PhoneApplicant — Number of ChildrenSpouse or Co-Applicant — NameSpouse or Co-Applicant — TitleSpouse or Co-Applicant — Street AddressSpouse or Co-Applicant — City, State ZIPSpouse or Co-Applicant — Home PhoneSpouse or Co-Applicant — Mobile PhoneSpouse or Co-Applicant — Marital StatusSpouse or Co-Applicant — Number of Children
    Show the rest of the form (4 more sections)
    Employment
    Applicant — EmployerApplicant — Employer Street AddressApplicant — Employer City, State ZIPApplicant — Position/TitleApplicant — Business PhoneApplicant — Years with EmployerSpouse or Co-Applicant — EmployerSpouse or Co-Applicant — Employer Street AddressSpouse or Co-Applicant — Employer City, State ZIPSpouse or Co-Applicant — Position/TitleSpouse or Co-Applicant — Business PhoneSpouse or Co-Applicant — Years with Employer
    Household income
    Applicant — Wages (including salary, bonuses, tips and self-employment income)Applicant — Wages FrequencySpouse or Co-Applicant — Wages (including salary, bonuses, tips and self-employment income)Spouse or Co-Applicant — Wages FrequencyInterest, dividends, royalty income — amount and frequencySocial Security, SSI — amount and frequencyDisability — amount and frequencyRental Income — amount and frequencyUnemployment — amount and frequencyChild Support — amount and frequencyAlimony — amount and frequencyPublic Assistance — amount and frequencyRetirement income, trusts, pension payments — amount and frequencyOther — amount and frequency
    Health coverages available for payment
    Insurance PlanEnrolled MemberInsurance IDGroup IDHealth share plans/ministries — Plan Name or Do Not HaveShort-term health insurance — Plan Name or Do Not HaveLimited-liability health insurance — Plan Name or Do Not Have
    Consent and agreement
    Applicant — SignatureApplicant — DateSpouse or Co-Applicant — SignatureSpouse or Co-Applicant — Date

    Have ready

    • Completed 2026 Financial Assistance Application.
    • Two most recent pay stubs for every employed household member.
    • Most recent Form 1040 tax form for the entire household.
    • Profit and Loss Statement for each self-employed household member.
    • Signed Financial Support letter from the person supporting the household when the applicant is not employed or cannot provide pay stubs.
    • Employment verification letter from the employer when the employer does not provide pay stubs.
    • Copy of government-issued identification.
    • Proof of family size.
    • Proof of county of residence for Hughes Spalding applicants only.

After you send

Call 404-785-5515 with questions or if follow-up is needed after submitting a complete packet. Notify CHOA if additional medical services occur after the application is submitted. If you have not heard back in two weeks, write and ask whether it arrived.

Full record, as published