Become a patient
You must meet qualifications and submit a completed application and required documents before medication or medical services can be given.
There are three ways you can get an application to begin the process:
1
Call 941-445-5687 to be pre-screened and to pick up an application.
When your application is completed, call 941-445-5687 for an appointment to come in to finalize your registration. Be sure to bring the following items with you when you finalize your registration.
- Photo ID
- Copy of latest tax return
- Copies of your proof of income for the last 4 weeks in the form of pay stubs, social security or unemployment statements for every member of you household
- Prescription bottles of valid written prescriptions