Current year's tax form (1040 form)
2 current pay stubs
1 unemployment stub
Letter from employer on letterhead that states your salary or wages
If none of the above are available, you must provide a letter of reference from any 501(c)(3) (non-profit) organization on their letterhead (for example, your church).
Discount levels for qualifying patients based upon household size are shown in Link below.
Percent shown is the amount of discount.
Effective February 1st, 2007 Family Health
Centers will require a minimum fee of $15.00 for class A patient visits.
For the 2012 Sliding Fee Scale Please Click
the link Below