As an affiliate of Northside Hospital, Inc. we are committed to fulfilling Northside’s charitable mission as a health care provider. Uninsured, underinsured and Medically Indigent Patients having limited or inadequate resources to pay for Medically Necessary Services rendered at a our Practice may be eligible for full or partial Financial Assistance through Northside’s Physician Practice Financial Assistance Program “PPFAP”. Please complete this application and mail it to address listed in this application.