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TO BE ELIGIBLE TO RECEIVE SERVICES FROM

WARREN COUNTY FREE CLINIC, INC.

YOU MUST BE UNISURED

Do Not Have Health Coverage

Household Income Below the 250% of the Federal Poverty Level

FOR EXAMPLE:

    FAMILY SIZE                  INCOME

           1                        $24,500/Yearly Gross

           2                        $33,000/Yearly Gross

            3                        $41,500/Yearly Gross

  ( add $8,500 for each additional person)

ELIGIBILITY

Be a Resident of Warren or Vance County

and Present Proof of Residency

(For example:  Mail addressed to you at your residence)

 

•  Not a Military Dependent

•  Over 18 and Under 65 Years of Age

•  Have Photo Identification

•  Present Proof of Household  Income

   Including  Current Income Tax

and

Clinic Registration Form
Click & Download

If you are are a resident of Warren  or Vance County preparing to visit the Warren County Free Clinic for the first time, we have provided information and forms for your review and preparation to expedite your visit.  Please click, download and print.

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