Eligibility

Eligibility

To become a patient of Grace Clinic, you must first call us at 336.835.1467 for an appointment to become qualified.

Eligibility Requirements:

  • Between the ages of 18-64.
  • Resident of the following zip codes: 27011, 27017, 27018, 27020, 27055, 28621, 28635, 28642, 28669, 28670, 28676, 28683, 28685
  • No medical insurance.
  • Income at or below 200% of Federal Poverty Level.

What to Bring:

  • State-issued photo identification showing your current address.
  • Additional proof of where you live: Proof of Residence: Utility Bill, Car or Voter Registration, Lease Agreement, Phone Bill, Cable Bill (bring one).
  • Any other government issued identity cards.
  • A list of everyone in your household – names, ages, and relationship to you.
  • Proof of household income.
  • The bottles for any medications, supplements, or vitamins that you take or have recently taken.
  • Medical records.
  • A list of your health questions or concerns.

Accepted Proof of Income Documents:

  • Copy of previous year’s tax return.
  • W-2’s
  • Stubs from paychecks or benefit payments.
  • Award letters for child support, Social Security, unemployment assistance, veteran’s benefits, or Work First.
  • Copies of alimony checks.
  • A description of any help that you receive from other people, ministries or agencies.

 

For a copy of our Patient Non-Discrimination Policy, please click here.