Become a Patient

How to become a patient at the Pulaski Free Clinic:

Ready to become a patient?

The Pulaski Free Clinic accepts anyone who has Medicaid or:
 

  • Is a resident of Pulaski County, and

  • Is over 18 and under 65 years old, and

  • Is not insured and

  • Is considered “Low-Income” as defined by the state of Virginia, meaning that your entire household income falls at or below 300% of the Federal Poverty Guideline.

You qualify if your total household income is:

$40,770 for 1 person (just one person living in the household)
 

$54,930 for 2 people (including children) living in the household
 

$69,090 for 3 people 
 

$83,250 for 4 people 

I meet all of the requirements. So, how do I become a patient?

Call the clinic at (540) 980-0922 to schedule an intake screening.

You will need to bring all of the following things to your intake appointment:
 

  • Identification card or driver’s license

  • Proof of Pulaski County residency (water bill, letter from government agency, etc.)

  • Proof of income for the entire household 
    ​If you are unsure about this, please ask when you call us

  • Last 30 days of pay stubs if employed

          (or)

  • Income records if self-employed

  • Most recent Federal income tax return if you or anyone in your home filed taxes last year

  • Letter showing unemployment benefits, disability benefits and/or social security benefits for everyone in your home

  • Medicaid denial letter if you have received one (very important!)
     

       Please bring anything that you feel will help us to prove your income

Forms that you can print, fill out at home, and bring with you to your screening appointment:

Eligibility Form

Confidentiality

Consent

Appointments