• Live in Franklin or Ripley County
  • No Health Insurance
  • High Deductible Insurance ?
  • Must show proof of income (household) less than 300% Federal Poverty Level (FPL)

2021 Eligibility 300%FPL

Household MembersMax Income allowed
1$38,280.00
2$51,720.00
3$65,160.00
4$78,600.00
5$92,050.00
6$105,480.00

New Patient Forms.

If you would like to complete the required forms prior to your first appointment, please download and complete and bring with you on your first appointment along with proof of income.

Click here for forms.