Become a Patient
Become a Patient at Volunteers in Medicine | Patient Qualifying Guidelines
Your health is important to us. Volunteers in Medicine Jacksonville is a free clinic for the working uninsured offering primary care and 15 specialties. We focus on the health of the whole person with the help of 300+ volunteers. Everything we do is FREE for you. Please fill out the form below and schedule a phone call with one of our qualifying volunteers to get started. Read what others have to say about the care they receive at Volunteers in Medicine.
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Video on how to become a patient At Volunteers in Medicine
Volunteers in Medicine | Patient Qualifying Guidelines
Be an adult between the ages of 18 - 64
You or your spouse/partner work at least 20 hours per week
Be uninsured and currently without health insurance
Have a household gross income before taxes that falls within the income range listed below
Household Income Requirements:
| Persons in family/ household |
Qualifying Minimum |
Qualifying Maximum |
||
|---|---|---|---|---|
| 1 | $14,560 | $51,870 | ||
| 2 | $14,560 | $70,330 | ||
| 3 | $14,560 | $88,790 | ||
| 4 | $14,560 | $107,250 | ||
| 5 | $14,560 | $125,710 | ||
| 6 | $14,560 | $144,170 | ||
| 7 | $14,560 | $162,630 | ||
| 8 | $14,560 | $181,090 | ||
Required Documentation:
Government Issued Photo ID
Proof of Income (Any of the following for ALL working adults in the household)
4 weeks (1 month) of most current pay stubs
Signed letter from your employer stating hours worked and pay rate on company letterhead
Self-employed applicants: 3 months of bank statements
Important Things to Know:
Have your photo ID and all proof of income documents ready to be uploaded when you start the application. If you do not upload all of your documents during the application, it will delay the process, and we will not be able to qualify you as a patient.
If you and your spouse/partner are both working, proof of income must be uploaded for BOTH of you.
All income documents must contain your name and dates. For paystubs, they must include gross pay. For bank statements, they must include total deposits. We cannot accept W2s, tax returns or screenshots of pay apps.
At the end of the online application, you will be asked to select a time for a phone call with a qualifying volunteer. Please make every effort to make that call.
Check your email! We may require additional documents or have questions about your application.
To qualify to become a patient at our South San Marco or West Jacksonville Clinic, please fill out the form below.
If you need additional assistance with the form below, please email Qualify@vimjax.org and provide your full name, the clinic to which you would like to be referred (South San Marco or West Jacksonville), and one month of paystubs. (If self employed, please include 3 months of bank statements.)
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If you are an existing patient and need to requalify, use this form instead.