Registration

How to Register 

To access the Clinic’s services, you must first register to become a patient of the Clinic. Registration takes place on a first-come, first-served basis on Mondays evenings (except for Monday holidays).  Please come to the Clinic by 5:00 p.m. on Mondays.  The Clinic registers patients from 5:00 p.m. to 7:30 p.m. on Mondays.

Financial Information Required as a Part of Registration

When you come to register, please bring the following information with you.  Please note that all required paperwork needs to be completed and submitted before you can receive any services from the Clinic.

  • Proof of residency in Powhatan County
    • Driver’s license or
    • Utility or medical bill or any mail you have received that has your name and current address on it
  • Current 1040 Federal Income Tax form (if filed) and schedule C if you are self-employed
  • Proof of all household income for one month (as applicable):
    • Most recent month’s pay stub(s)
    • Unemployment award letter
    • Food stamp (SNAP) award letter
    • Social Security letter with the amount you receive or copies of your SSA check
    • Disability benefit statement letter or disability checks
    • Any retirement or pension documentation
    • Child support letter
    • If you have applied for Medicaid, we need a copy of the determination letter
    • If you have applied for disability, we need a copy of the determination letter
  • Note:  The following are considered members of your household:  yourself, your spouse, your minor children, disabled children over the age of 18, and grandchildren for whom you have custody.  You must bring corresponding financial information for each member of your household as well.

Registration & Recertification

Every twelve months from the registration date or last recertification date, all patients must recertify to remain eligible to receive services and medications from the Clinic. You must continue to meet the Clinic’s eligibility and financial criteria. The same process and financial information required to register are also required to recertify.

Recertification takes place on a first come, first served basis on Mondays evenings (except for Monday holidays). Please come to the Clinic by 5:00 p.m. on Mondays. The Clinic recertifies patients from 5:00 p.m. to 7:30 p.m. on Mondays.

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