Ready to apply?
You must meet qualifications and submit a completed application and documents before medication or medical services can be given.
3 WAYS TO GET CLIENT APPLICATIONS
- Call 941-445-5687 to be pre-screened and to pick up an application.
- Download and print the application using the download links.
- Patients of SMH Newtown Clinic can apply in Newtown. Contact Luldes Serrano: 941-445-5687 or luldes@goodsamrx.org
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.
- Your photo ID.
- Copy of your 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 your household.
- Prescription bottles or valid written prescriptions.