Become A Patient
In order to enroll as a patient, you must meet all three (3) of the following criteria:
- Be a resident of Florida
- Must not have healthcare insurance or be enrolled in any government sponsored healthcare programs: Medicaid, Healthy Kids, Kidcare, Share Cost, Medically Needy, Medicare or VA.
- Fall at or below the 200% federal poverty level.
All applicants are required to submit the following documents:
Examples:
- a paycheck stub
- a letter from your employer (on business letterhead including company name, address, and phone number)
- unemployment forms
- a notarized letter from head of household who is financially responsible
Examples:
- driver’s license
- consular identification card
- passport
- other recent I.D. with name and photo such as big box store or school
- phone bill, power bill
- car registration or insurance
- other correspondence addressed to patient