Patient Information
Eligibility
- **NOW SEEING CHILDREN**
Must be a resident of Hardin, LaRue, Meade, Breckinridge or Grayson County
Must be uninsured
Receiving disability income WITHOUT medical coverage
Items Needed During Screening Appointment
Photo ID
Proof of residency (home address, if ID not current)
Proof of household income (anyone on the same tax forms)
Previous 2 months pay stubs
Unemployment letter/stub
Social Security/Disability Statement
Child Support
Self-Employment
Current Years Taxes
Current bottles of medication, even if empty
Information of previous provider

Screening Appointment
If you feel you meet these qualifications and would like to become a patient of the Clinic you will need to call and schedule a screening appointment. At this appointment, you will not see a provider. You will need to fill out the Clinics registration forms, just like paperwork at any doctor’s office. We will need to get some information from you showing that you do qualify for services at the Clinic.
**FASTING LABS will be done at the screening appointment. This is for the doctor to have baseline labs to go by at your first doctor’s appointment. This means nothing to eat or drink after midnight the day before your screening appointment.
Services Provided to Those Who Qualify
*Basic health care to those who qualify
*Health counseling & advocacy
*Extensive care coordination
*Chronic disease management
*Mental Health Services
*Individual diabetes education
*Physical Therapy
*Prescription assistance to the uninsured/underinsured
*QHP, Medicaid, SNAP, & CCAP enrollment & advocacy
(health insurance, food stamps, and child care assistance)
*Medicare enrollment and plan review & renewal
*Assistance with durable medical equipment
*On-site licensed volunteer pharmacy
We have an on-site kynector. If you need assistance with your kynect account, applying for Medicaid, Qualified Health Plan (QHP), SNAP (Supplemental Nutrition Assistance Program/Food Stamps), or Child Care Assistance Program (CCAP), WE CAN HELP. Call us for information.
**Jessica Dailey, 42701 – Medicaid/KCHIP/APTC/QHP, SNAP, Child Care Assistance – Public kynector**