Financial assistance programs & policies Apply online Financial assistance program Sliding Fee Scale Program Financial assistance policy Contact us Apply online Please be sure to include in your message the patient's name. If you wish to contact the business office by phone please call us at (888) 214-4065. * indicates a required field Patient information Patient name * Date of birth * Hospital account no. * Facility name * - Select -Children's HospitalForest HillsFranklinGlen CoveLenox HillLong Island JewishNSLIJ AmbulanceNSUH - ManhassetNSUH - SyossetPlainviewStaten IslandSouthsideZucker Hillside Your information Your name * Your relationship to patient * - Select -SelfSpouseParent of minor childLegal guardianAttorneyPower of attorneyEstate executor Your email address * Yes, I certify that I am the owner of the email account and am the patient, the legally responsible party for the patient's account, or I am authorized to act on behalf of the patient. * Message information Subject * Message By providing your email address, you agree to receive email communication from Northwell Health.