Transplant Referral Form

Due to visitor restrictions in place due to COVID-19, we are asking that patients who want to pay their bill use alternative means and not come to the facility for an in-person payment. Alternative means include telephonic or electronic means as identified on your physical statement. Access to the facility to pay your bill in person will be denied until such time as the COVID-19 resolves within our service area. We apologize for this inconvenience. Please know Memorial Health is committed to ensuring safety for both you and our providers.