Family Health Centers requires patients to show proof of income to qualify for
our sliding fee scaled “discounts”. The following are examples of proof of
income that you can bring. Please note there may be other types of proof not
listed here.
Current Pay Stubs
Completed 1040 tax
form from last year’s
income tax
Child support
(copy of court order or
copy of check)
Letter for Social
Security, SSI, Disability,
Unemployment, etc.
Letter from your
employer on
company letterhead
that gives your pay
rate and the number
of house worked each
week
Letter that shows you
receive other Public
Assistance
(food stamps, etc.)