What Do I Bring?

New patient applications accepted on:
Monday , 9 a.m. to 3:00pm (We are closed for lunch from 12-12:30pm)

Please bring COPIES of the following
when you come in to submit an application:

• Proof of Income (i.e., four pay stubs, food stamps, pension, social security, child support)
• Last year's federal tax return & W2's
• Driver's license or state ID
• Proof of residency (i.e., utility bill, bank statement, charge card or cell phone bill)
• Income information for others in the household ((i.e., husband, children, significant other)
• Denial letter from Medicaid, Social Security Disability, Healthy Start/Healthy Family
• Full-time employees: letter from employer that you are not eligible for health insurance
• A list of current medications