To become a patient of the Free Medical Clinic you must participate in our eligibility screening.
Visit the Clinic during scheduled screening times:
Monday and Wednesday 1:30pm-3pm
Thursday 5:30pm-7pm
(No Screening on the 5th Thursday of the month)
Eligibility Criteria:
- Reside in Winchester, Frederick or Clarke County (minimum of 90 days)
- Have No form of Health Insurance
- Meet Income Requirements based on the Federal Poverty Level
Bring the following documentation to be considered during screening times:
- Proof of residency (examples include: current Virginia Driver’s License or Virginia ID; current gas, electric or water bill; or, current lease/rental agreement with letterhead and contact information)
- Current 1040 Federal Income Tax form including W-2(s) and 1099
- Proof of total household income for three months
Examples of Proof of Income include*:
- Pay stubs from current employer for the past 3 months
- Food stamp award letter
- Notarized letter of support from whoever is providing shelter and food (provided by Clinic)
- Proof of Social Security (award letter, copy of a check OR copy of a bank statement showing deposit)
- Proof of Disability income (award letter, copy of a check OR copy of a bank statement showing deposit)
- Proof of Supplement Security Income – SSI (award letter, copy of a check OR copy of a bank statement showing deposit)
- Proof of pension (award letter, copy of check OR copy of a bank statement showing deposit)
- Proof of Unemployment (award letter, copy of check OR copy of bank statement showing deposit)
- Proof of child support (copy of court order, canceled check, or receipt)
- Schedule C tax forms if you are self employed
- Current three months bank statements
*Other documents may be requested upon review of application.