Patient & Visitor Information

RGH County Charity Program

If you need help with your hospital bill and you do not qualify or have been denied by the County for the Indigent Program, you may apply for the RGH Charity Program.

Guidelines for Roosevelt General Hospital Charity Program:

1. Residents who present proof of living in Roosevelt County.

2. Residents who meet Income Criteria as follows:

Monthly Guidelines

Charity Program Application Forms:

Financial Assistance Required Information

Charity Application/Signature Form

Charity Application/Signature Form - Spanish

For more information contact:

For patients with the last name starting A-L, contact Ermini Chavez at 575-356-3410

For patients with the last name starting M-Z, contact Jennifer Perez at 575-226-6618

Roosevelt General Hospital
42121 US Hwy 70
Portales, NM 88130
Phone: 575.356.3410
Fax: 575.356.9200