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Become a Patient

 

VBA Clinic volunteer doctor and 2 nursesPatient Eligibility for Semi-urgent Medical Services

  • Must be a resident of Charlotte County, Florida
  • At least 18 years of age
  • Have no Medicaid, Medicare or private health insurance
  • Annual household income must be at or below 300% of the      Federal Poverty Level for the size of your family.
    • For a family size of one (a single person), that means you can earn up to $47,880 per year (approx. $3,990 per month)
    • For a family of four, the limit is $99,000 per year (approx. $8,250  per month)
    • These figures are based on US DHHS Federal Poverty Guidelines (Federal Register; 1/21/26) and are subject to change without notice. Get the information here.
    • Some exceptions may apply; please call 941-766-9570 for more information.

You will need the following documents at your first screening appointment in order to complete your eligibilty screening:

Download and print this Patient Packet. (2.3 Mb file size) If you have any questions as you are filling out your packet and gathering the supporting documentation, please don’t hesitate to call the Clinic at 941-766-9570.

1. Photo identification

2. Proof of current Charlotte County address – 1 document of proof

  • Examples of documentation – photo ID, utility bill, lease/rental agreement, current pay stub with address, vehicle registration

3. Provide Proof of income or Explanation of How You Live With No Income – Needed for all family members (i.e. patient/spouse/significant other/child)

  • 1) Current Social Security Earnings Statement
    2) Previous year Income Tax Return or proof you did not file
  • 3) 1 month of current pay stubs needed for each member of the family
    4) Current Bank Statements (all checking & savings) needed for each member of the family
    5) Current Unemployment letter stating amount to be received needed for each member of the family
    6) Current Social Security Benefits (retirement, disability, dependents, and survivors) award letter stating amount to be received needed for each member of the family

Once packet is complete, and all supporting documentation has been gathered, please call the Clinic at  (941) 766-9570 to make a screening appointment.