To qualify for care at the medical clinic you must be within 300% of the Federal Poverty Guidelines and to qualify for the pharmacy you must be with 300%. Treatment at our clinic is held on Monday nights from 5 to 7 pm at 610 Central Center, Chillicothe.
If you are a new patient, printing and completing these forms before arriving at the clinic will help facilitate a shorter wait time.
- Welcome Letter (Spanish)
- Registration Information (Spanish)
- Health History (Spanish)
- Consent for Treatment (Spanish)
- Tort Notification
- Patient Satisfaction Survey (Spanish)
If you are a returning patient, please print and complete the following forms to bring with you.
The pharmacy is open from 4:00-8:00 PM each Monday; please complete the Charitable Pharmacy Certification Documents (Spanish) before bringing your prescription. Please check the calendar to confirm the clinic will be open.
We accept male and female patients from all age groups.
