Apply Online

Need healthcare? Please fill out the following short form to see if you qualify for HNG.  A member of our staff will contact you.  If you have questions, please call 704-874-1901.

Note:  Chronic medical conditions include diabetes, high blood pressure, asthma, heart disease, COPD, etc.

2013 Poverty Table

* 1. Are you a Gaston County resident?
 Yes No

* 2. Are you age 18 or older?
 Yes No

* 3. Is your household income 100% of federal poverty or less based on the table shown below?
 Yes No

* 4. Do you have any kind of health insurance (private insurance, Medicaid, Medicare, VA benefits)?
 Yes No

* 5. Do you have a chronic medical condition?
 Yes No

* Your Name

* Your Email

* Your Phone Number

* Indicates required field.

 

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