Documents To Bring

First-time patients should print, complete and bring-in a registration form. Please choose either:

If you register by phone, we will collect your registration information so you only need to show documentation when you arrive at one of our health centers. We will need to review these documents again annually or any time the information changes. As part of the registration process, we will determine your payment source. We accept all major insurance plans. Please bring the following:

• Photo ID (if applicable)

• One of either:

  1. Insurance card – please bring one of the following if applicable.
    • Commercial Insurance:  your most recent insurance card.
    • Medicaid:  your most recent Medicaid card (Peach State, PeachCare for Kids, Wellcare, GHP or Amerigroup).
    • Medicare:  your red, white and blue card or the card provided by your Medicare HMO.

  2. Proof of income - one of the following is required as proof of income:
    • A minimum of two (2) paycheck stubs, no older than 30 days.
    • If you currently are not receiving income, you must present a Wage Inquiry form from the Georgia Department of Labor, no more than 30 days old.
    • If you are self-employed, you may choose to show a recent tax return.
    • If you are paid in cash, you will need to provide a letter from your employer stating your rate of hourly pay, amount paid each pay period, and how often you receive payment.

• Proof of address in the form of a utility bill, lease agreement or homeless shelter letter.



Back to For Patients >>

 

Accreditation

 
Connect