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 public or private health insurance
  • Annual household income must be at or below 200% of the Federal Poverty Level for the size of your household.
    • For a single person, that means you can earn up to $25,250 per year
    • For a family of four, the limit is $52,400 per year (approx. $1,092 per week)
    • The limit varies depending on the number of people in your household
    • These figures based on US DHHS Federal Poverty Guidelines (Federal Register; 1/22/20), and are subject to change without notice. Get the flier 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 receive services:

Download and print this Patient Packet. Filling in your information ahead of your appointment will speed up your visit. If you are unable to perform this task, please do not worry – we will help you complete it when you come in.

1. Photo identification

2. Proof of address: If your photo identification does not show your current Charlotte County address, you will need to bring one of the following:

  • 2 pieces of mail with your current address
  • Vehicle registration
  • Copy of lease or rental agreement
  • Letter from the Charlotte County Homeless Coalition
  • Current pay stub showing your address
  • Letter from a benefit agency
  • Utility bill

3. Proof of income: You will need income verification for yourself and spouse/significant other living in the home

  • Current tax return
  • 1 month of current pay stubs
  • Unemployment letter
  • Current SNAP benefits
  • Social Security award letter
  • Bank statement
  • Social Security Earnings letter (may obtain online at

Please call the Clinic in advance if you do currently have a screening appointment.  (941) 766-9570