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Patient Financial Assistance

Patient Financial Assistance Information


Dear Patient,

At Acutis, patient care is our number one priority.

We do understand that laboratory testing, while medically necessary, may cause a patient’s unnecessary financial burden. In accordance with state and federal laws, Acutis offers a Financial Assistance program to those who qualify.

In order to determine if you qualify for the program, we request that you complete the Financial Disclosure application form and provide the requested documents listed below:  

• A copy of the most recent pay stub(s)  
• A copy of the previous year’s tax return 
• Verification of unemployment  
• A proof source indicating that you are eligible for local, state, or federal assistance programs  

We will review your application and documentation to determine if you qualify for the program. Upon determination, you will receive a notification letter about whether you qualify.  

Thank you for being an Acutis patient!  


Acutis will work with all patients to resolve their balances: we have a dedicated team available to assist you.

Please contact us with any questions or concerns
844-522-8847 + Option 3
Available Monday - Friday from 9 am to 5 pm


Please complete the Financial Disclosure Assistance Application

Fill the application here

Print it, and return it to the Acutis headquarters by mail:
400 Karin Lane, Hicksville, NY 11801