Eligibility Requirements


(For families/households with more than 8 persons, add $8,640 for each additional person.)

 # in household 100%  200% limit
1 $12,140 $24,280
2 $16,460 $32,920
3 $20,780 $41,560
4 $25,100 $50,200
5 $29,420 $58,840
6 $33,740 $67,480
7 $38,060 76,120
8  $42,380 $84,760

1. Determine how many people in your household are living off of the combined income in your home.

2. Calculate how much you make in a single year between all household income makers.

3. Economic qualification = If the total annual income is less than 200% of the current 2018 Federal Poverty Guidelines for your family size.

Download / print the 2018 Eligibility Guidelines.

Lack of Insurance Standard

You may not have private, public, or self-purchased health insurance or benefits (including Veterans Administration, Medicaid or Medicare.) This also applies to dental services at the clinic even if your health coverage does not extend dental benefits.

Screening Process

Each patient is screened for eligibility at the clinic during the first appointment and re-screened every six months; thereafter. You MUST bring proper documentation to your first appointment or you will be turned away when you arrive. Eligible patients are those with no health insurance of any kind with a financial household income of 200% or less of poverty federal guidelines.

Requested Documentation

Current picture identification

Social security card or number (not required for service)

Verification of Income (pay stub, W-2 form, Tax return etc. from all working members of the house in which you live)

Medical and/or Prescription history paperwork

Service Restrictions

The scope of care provided by the clinic is limited due to the volunteer nature of our clinic. Our staff will select patients for registration based on our ability to professionally meet their overall healthcare needs. We cannot guarantee any patient will be admitted for care and will do our best to refer you to appropriate resources.

Patients are not refused service based on race, religion, gender, sexual orientation, national origin, age, residency status, or for any other non-financial/non-medical reason.

If you do not speak English you need to bring a translator with you to your appointment (Si usted no habla Inglés que tiene que traer un traductor con usted a su cita.)