Be a Volunteer

You are a vital part of the community!

Patient Application

Eligibility Requirements

Medical Eligibility

  • Patients MUST Reside In: Northeast Tennessee or Southwest Virginia
  • Patient and/or someone in their household MUST be employed, unless they are retired or a student
  • Patient must have NO Private Medical, TennCare/Medicaid or Medicare Insurance

Dental Eligibility

  • Patients MUST Reside In: Northeast Tennessee or Southwest Virginia
  • Patient and/or someone in their household MUST be employed, unless they are retired, a student, a Veteran, or disabled
  • Patient must have NO Dental Insurance

Vision and Chiropractic Eligibility

  • Patients MUST Reside In: Abingdon, Virginia; Bristol, Tennessee / Virginia; Blountville, Tennessee; Bluff City, Tennessee; Elizabethton, Tennessee; or Piney Flats, Tennessee
  • Patient and/or someone in their household MUST be employed, unless they are retired or a student
  • Patient must have NO Private Medical, TennCare/Medicaid or Medicare Insurance.

Financial Guidelines

Eligibility is based on total household income which may not exceed 200% of the Federal Poverty Guidelines. All applicants must bring their most recent paystubs, tax returns and income information for all members of their household.

PLEASE READ CAREFULLY
One Application per Person

Thank you for expressing an interest in becoming a patient of Healing Hands Health Center. We are a faith based ministry providing healthcare to uninsured residents of NE Tennessee and SW Virginia.

Please complete the attached application and medication record in black ink, and bring it with the documentation listed below to the clinic on one of the designated enrollment days. These times are first come first served. Enrollment days are:

  • Monday: 2:00 – 4:00 PM
  • Tuesday: 4:00 – 6:00 PM
  • Wednesday: 10:00 AM – Noon
  • Thursday: 4:00 – 6:00 PM

Please check our Facebook page for additional screening times that are periodically offered.

If the required eligibility documentation is not provided, you will be asked to return on another enrollment day.

 

For Dental Services Only:

  1. Proof of income for you and everyone in your household
  2. A current piece of mail (preferably a utility bill) received at your address in your name (not junk mail)
  3. Child Support (if you receive) documentation
  4. Your Social Security card
  5. Your Photo ID

 

For Medical, Vision, Chiropractic, and Counseling Services:

  1. Tax return AND most recent paystubs for each employed member of your household. Patient and/or someone in the household MUST be employed, unless he or she is retired or a student.
  2. If you are self-employed you must provide documentation of all work done in the last 30 days (invoices, schedule book, etc.) or current 1040 tax return.
  3. Students not working need to provide their current class schedule.
  4. Child Support (if you receive) documentation
  5. Award letters for Social Security benefits, VA benefits and any other pensions (if applicable)
  6. A current piece of mail (preferably a utility bill) received at your address in your name (not junk mail)
  7. Social Security card
  8. Your Photo ID

Patient Fee schedule (Effective April 1, 2016)

Medical Patient Visit $25
Dental Patient Visit $30
Dental Hygiene Visit $20
Vision Patient Visit $20
Eyeglasses (Frames and Lenses) $25
Chiropractic Patient Visit $15
Counseling Patient Visit $15
Physical Therapy Patient Visit $15
Medication Admin Fee $5/med*

*$35 cap per visit