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New Patients: Text
NEW PATIENTS
-
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.
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.
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)
Income Levels to Access Free Clinic Care
(including pharmacy, dental, and ancillary services (labs, X-rays, & specialty care from Sentara RMH)
Family Size
Medicaid
(income up to 138% FPL)
1
2
3
4
$22,024
$29,863
$37,701
$45,504
Sentara Free Care
(income up to 300% FPL)
$64,920
$47,880
$81,960
$99,000
Based on 2026 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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