• Submit Your Files for Review

    Please fill out the form below and upload your files for review. Please allow for three business days for your information to be processed and for your case manager to contact you.
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  • Reminders for Common Types of Proof of Income:

    1. Paystubs: Must submit a total of three month's worth of paystubs (90 days). Paystubs must be from the last three months. The name of the employee, the pay period, and the gross income must be visible. 
    2. Letter of Employment: Must include how much the employee earns per hour and how many hours per week they work. Must be signed and dated by the employer.
    3. 2021 Tax Returns: Typically, only the first page of the 2021 1040 needs to be submitted. If you are self-employed and filed a Schedule C, your case manager may request the first page of this document as well.
    4. Food Stamps: Must include how much is received monthly. The recipient's name and as well as the date of the letter must be visible.
    5. Letter of Support: Must be fully filled out, signed, and dated by the supporter. 

    Reminders for Proof of Residency:

    In order to qualify for PAWT, patients must reside in Tennessee. Below is a list of acceptable documents to verify proof of TN Residency. If you do not have one of the below-mentioned documents, please reach out to the PAWT office.

    • TN Driver’s License / State Issued ID
    • Current Lease / Mortgage Contract
    • Utility Bill (electricity, internet, water, cellphone bill, etc.) *Must be dated within the past three months
    • Bank Statement *Must be dated within the past three months
    • Paystubs showing address *Must be dated within the past three month
    • Most Recent Tax Documents
    • matrícula consular card

    Reminders for Bills:

    Any bills being submitted should include the patient's name, the date of service, and the physician's name. 

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