Existing Patients

Requirements to Reenroll as a Patient

Read the following Information

If you do not have insurance we require:

  • Photo ID if you have one
  • Proof of address
  • Proof of income for you and your spouse if you are legally married
  • If you are paid weekly, we require your last 4 paystubs.
  • If you are paid bi-weekly, we require your last 2 paystubs.
  • If you are paid cash, then we require your employer to complete the employer verification form and provide two months of bank statements or statements from your financial institution (ex: Venmo, Cash App, Chime, PayPal etc.)
  • If you are self-employed, we need you to complete our self-employment form and provide two months of bank statements or statements from your financial institution (ex: Venmo, Cash App, Chime, PayPal etc.)
  • If you are currently not employed, we need you to complete our no income verification form, and the person helping you with your expenses must complete a verification of support form. Also, provide two months of bank statements or statements from your financial institution (ex: Venmo, Cash App, Chime, PayPal etc.)

If you have Medicaid insurance we require:

  • Photo ID if you have one
  • Proof of Address
  • Medicaid Card

Additional ways we can help

Read additional helpful information.

Patient Donations:

If you're uninsured, we ask for a $5 contribution per medical and mental health visits. The rest of the cost is covered by our partners and donors. We believe no one should have to choose between their health and essential needs so do not worry—we will not turn anyone away because of money issues.  

Need more assistance?

Contact our bilingual enrollment team at:

540.536.1614

Reenroll Now

Please use the link below to reenroll.