Eligibility

We are not a walk-in clinic. Before making an appointment at the Good Samaritan Clinic, you must first qualify by proving the following:
    1. You have lived in West Volusia County for 3 months or more (1 month if homeless)
    2. You have no applicable health insurance
    3. Your household income does not exceed 200% of the Federal Poverty Level (FPL). You can download and print the FPL table here.
    4. Your household assets do not exceed $5000 or $6000, depending upon the size of your household

You must prove these things by submitting documents (see our current application for the full list of required documents). Bring all your documents, a fully-filled application, your photo ID, and your social security card or birth certificate. All these will be returned to you.

You must appear in person with all your documents between 3 p.m. and 7 p.m. on Monday, Wednesday or Friday. No appointment is necessary. The interview will take from 30 minutes to an hour.

Qualification is effective for one year. Re-qualification is just like initial qualification.

There are three ways to obtain an application:
    1. You can call 738-6990 to request a mailed application.
    2. You can pick up an application on clinic days after 3 p.m.
    3. You can download and print an application here.

You are advised to read the application carefully and gather all requested documents before the interview. The sooner you provide ALL the requested documents, the sooner you may make an appointment.