To apply for services, please fill out the online application by clicking the ‘APPLICATION ENGLISH’ button (or ‘APPLICATION SPANISH’ for Spanish). There are four parts to the application:
Those applying for care must provide copies of the most recent tax returns for all family members. Family is defined as persons living together in a household who have a legal responsibility to each other.
New patients often have questions. Please take a look at our Frequently Asked Questions.
Once we have received and reviewed your application materials, you will be contacted to schedule your first appointment. If you have any questions about the application process, please feel free to contact us: 540-829-5032.
To support overall health and quality of life for our patients, the Free Clinic may refer patients to counseling, transportation assistance, Culpeper Human Services, literacy training, nutrition counseling, employment training, or other services available from local partner organizations.
1
$46,950
2
$63,450
3
$79,950
4
$96,450
5
$112,950
6
$129,450
7
$145,950
8
$162,450
9
$178,950
10
$195,450