Financial Assistance Application

View this page in Español or Kreyòl.

The application for assistance can be obtained by clicking the button below, or a paper copy can be mailed upon request, free of charge, by contacting the Business Office at 302-629-7946. If you need assistance completing this form, please email or call 302-629-7946.

Completed applications can be submitted to the Business office by mail, fax or in person.

  • By mail:
    Nanticoke Business Office
    801 Middleford Road
    Seaford, DE 19973
  • By fax: 302-628-6363
  • In person: The Business Office is located at 613 Water Street, Seaford, DE 19973. There is a second location within the hospital at 801 Middleford Road, Seaford, DE 19973. The office is located on the main floor just to the right of the lobby. The phone number for both locations is 302-629-7946.