Welcome To Central Care Community Health Center What To Bring To Your Appointment www.Centralcarechc.org Please bring the following along with your completed patient packet: The following will be needed for all household members (if applicable): • Martin Luther King Site 8610 Martin Luther King Houston, Texas 77033 713-734-0199 Photo Identification (Driver’s License, School, Military, Identification Card, etc.) • Proof of Insurance (Insurance Card); if applicable • Current medications Three (3) Proof of Income for all household members dated within the last 60 days; required for all uninsured patients that wish to utilize our sliding fee discount for charges applied to the deductible or noncovered charges. • • Household members include spouse, common-law spouse, live-in boyfriend/girlfriend Proof of income may include check stubs dated within the last 60 days, letter from employer on letterhead, social security award letter, most current tax return (required if you are a business owner) child support, unemployment, and/or a letter of support accompanied with a copy of the supporter’s ID and contact information. Third Ward Site 3315 Delano Houston, Texas 77004 713-831-9663 Acres Home Site 1102 Pinemont Houston, Texas 77018 281-822-0900 South Main Site 14085 South Main Houston, Texas 77035 832-954-7647 CCCHC Dental Center 3315 Delano Houston, Texas 77004 713-831-9655 Name: _________________________________ Appointment Date: __________________________ Time: ______________________________________
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