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New Patients: Text
NEW PATIENTS
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​Don't have insurance and not eligible for Medicaid? We'll see you.
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Don't have insurance and eligible for Medicaid? We'll help you get signed up.
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To make a medical, dental, or mental health appointment - the process is the same:
1) Call 540-705-0337​
OR
2) Request an appointment with the form below.
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A volunteer will contact you within 2 business days to setup an eligibility intake visit.
This is required for ALL new patients.
(Patients must show proof of household income to be scheduled for any services)​
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Income Levels to Access Care
(including free pharmacy, dental, & ancillary services (labs, X-rays, specialty care via Sentara RMH Medical Center)
Family Size
Sentara Free Care
(income up to 300% FPL)
$21,597
Medicaid Income (up to 138% FPL)
$29,187
$36,777
$44,367
$63,450
$96,450
$79,950
$46,950
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2
3
4
Based on 2025 income levels. Citizenship is not required for Free Clinic services.
*FPL = Federal poverty line
New Patients: Text
New Patients: Contact
NEW PATIENT APPLICATION FORM
Important! Before your first visit, please download and print these THREE forms. Bring the completed forms with you to save time!
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