New Patients

New Patients

 

We are glad you found us and happy to serve you.

“For I will restore health to you, and your wounds I will heal, declares the Lord” Jeremiah 30:17  

Take the survey

 

Requirements:

  1. You must live in Northern Virginia (Priority for Fairfax County). 
  2. You must meet our income guideline requirements, 200% of the Federal Poverty Line (FPL). 
  3. You must have no medical insurance, Medicare, Medicaid or affordable health insurance.

To get registered with our clinic, please complete the online application. After we receive your application, a member of our registration team will contact you within two weeks to request some supporting documents.

Screening:

Hope Clinic screens all patients prior to their first appointment with their physicians to determine eligibility for free clinic services. Upon submission of your application online, Hope Clinic will determine your eligibility. Hope Clinic will ask patients to provide certain documents to verify identity, residency, income, and insurance status.
To ensure that our physicians will see you on time, please arrive 10-15 minutes prior to your appointment time.

What documents do we need?

  •  Recent, valid photo ID such as Driving Licence.
  •  Proof of residency in Fairfax County for at least last three months, such as utility bill or letter.
  •  IRS form 1040 or W2 form for every earning member in the family and/or pay stubs for the last two months. Check yourself on Federal Poverty Line chart.
  •  Letter from employer to prove uninsured employee and/or a denial or approval letter of benefits from the government.
  •  In some case, if requested, a verification letter of support.

 


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