Leave a message with your name and phone number requesting a screening phone interview. A volunteer will
return your call to review the documentation you will need to bring to your registration appointment.
Schedule a Registration Appointment
Bring all requested documentation to your registration appointment
Eligibility will be determined after all documentation is received
Patients are notified by phone of eligibility. At that time an appointment will be made for services.
You may be asked to provide the following information
Valid Photo ID
Social Security Card
Proof of Residency
Proof of Income
If employed: paycheck stubs (last 2 months), most recent income tax return 1040, or financial statement
If unemployed: documentation of unemployment, Letter of Support
Proof of Benefits including:
Public assistance award letters (Food Stamps, Social Security, SSI, FAMIS)
We are a 501(c)(3) non-profit corporation staffed entirely by professional and administrative volunteers and generously supported by donations and grants. Registered patients are seen by appointment only. There are several clinics located in churches in Ashland and Mechanicsville.