Hospital financial support question
Hey guys, I live in Houston, TX with my girlfriend. We have a financial assistance program from the Harris County Hospital District (HCHD) that enables you to see participating doctors in the area on the cheap. She has problems that make it very hard for her to actually go out and accomplish (jobs, school, etc) that we need a doctor to help us through.
Part of the eligibility requirements entails us dropping off proof of her income. Because she's unemployed, they're asking me to sign a statement of support that asks where I earn my money and how much I give her a month:
What are the legal stipulations of signing and turning in this form? If say my girlfriend and I were to break up and she got hit by a bus the following day, would this form financially bind me to her?
We need a doctor to help her break out of whatever it is that's ailing her (right now we're guessing anemia) but I feel extremely uncomfortable signing anything for a system of hospitals that could potentially legally and financially bind me to a person indefinitely.
Thanks to anyone that takes the time to look through this and answer. I know I'm probably not talking about something right or not providing some key piece of information but she and I are pretty much flying blind through this whole process.
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