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/ Am I Eligible?
Am I Eligible?
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" indicates required fields
Do you currently have medical insurance?
*
Yes
No
Is your annual income at or below 300% of the Federal poverty guideline?
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Yes
No
Click here to see Federal Poverty Guidelines
Example:
If the federal poverty guideline for a household of 3 people is $22,000, 300% would be $66,000.
You meet our eligibility requirements.
New patients should bring the following to ATC Clinic:
Valid photo ID
List of current medications (if any)
Proof of household income
Completed application packet paperwork to review of your application
Download New Patient Packet
Unfortunately, you do not meet our eligibility requirements.
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