Eligibility

TO BE ELIGIBLE TO RECEIVE SERVICES FROM

WARREN COUNTY FREE CLINIC, INC.

YOU MUST BE UNISURED

Do Not Have Health Coverage

Household Income Below the 250% of the Federal Poverty Level

FOR EXAMPLE:

FAMILY SIZE INCOME

1 $24,500/Yearly Gross

2 $33,000/Yearly Gross

3 $41,500/Yearly Gross

( add $8,500 for each additional person)

ELIGIBILITY

Be a Resident of Warren or Vance County

and Present Proof of Residency

(For example: Mail addressed to you at your residence)

• Not a Military Dependent

• Over 18 and Under 65 Years of Age

• Have Photo Identification

• Present Proof of Household Income

Including Current Income Tax

and