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We can help people who meet all of the following criteria:
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  • Live in Newton, Jasper, or Walton County, GA 

  • Are age 18 or older

  • Have no health insurance for doctor visits

  • Have low household income (within 200% of the Federal Poverty Level). 

    • A household is defined as yourself, your legally married spouse, and any children in your custody who are under 18.

    • Contact us for help if you are unsure if you meet the income requirements.

                                             

New patient intake:​​

We complete new patient intakes Tuesdays, Wednesdays, and Thursdays from 8:30 am-4:30 pm. 

 

INTAKES ARE BY APPOINTMENT ONLY​

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Please download the application below, complete it, and bring it to your appointment with your relevant documentation:

Please schedule an appointment with our staff and be sure to bring the information below:​​​​​​​​​

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  • New Patient Application

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  • Proof of identity (bring one)

    • Picture ID (ideally a Driver's License, State-issued ID, or Passport)​

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  • Proof of Newton, Jasper, or Walton County residency (bring one)

    • Some sort of mail or a bill that comes to your address in your name (ideally a utility bill)

    • If currently unhoused, please let our staff know at your eligibility appointment.  This will not deter us from providing treatment.​

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  • Proof of income (or no income) for you and any legal spouse (bring one) 

    • 1040, 1099, or W2 Form for last year

    • Check stubs for your 30 days of work (you can text or email screenshots if information is on your phone)

    • Unemployment benefit information for the last 30 days

    • Food Stamp Award Letter or official documents from another Social Services Agency that lists your income

    • Disability or Worker’s Compensation Notification Form with your payment amount

    • If you have not worked and have no income, go to the GA Department of Labor in Covington and ask for a copy of your "wage statement" 

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  • Letter of Support

    • If you are supported by another person, whether for housing, food, or another way, please CLICK HERE to download our form.  Please have your support person sign it and bring it with you to your eligibility appointment​

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  • List of your monthly expenses

    • This will help you complete your new patient paperwork

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