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Our EMS Cost Recovery Program policy includes financial hardship provisions. You may contact McKesson directly by calling 1-877-967-6333 to request a payment plan if you are unable to pay the fees all at once. Or you may request a Financial Hardship Certification Form. If eligible, fees could be adjusted or waived. The financial hardship certification form must be submitted to the fire chief or his designee. Applications will not be processed without the required documentation, which includes proof of income that meets federal poverty guidelines. The city's financial hardship standard shall be based upon the federal poverty guidelines published annually by the United States Department of Health and Human Services (or successor agency if such is established). Hardship waivers shall be granted if the patient's "adjusted gross income," as established by their federal tax return, is less than two hundred (200) percent of the published poverty rate. The rate shall be established effective July 1 of each year and shall remain effective until June 30 of the succeeding year. If you have questions, please contact our Emergency Medical Services Branch office at 757-727-1202. The Financial Hardship Certification Form should be mailed to: Hampton Fire & Rescue EMS Branch 1300 Thomas Street Hampton, VA 23669