You’ve made a great first step toward caring for yourself!

Having regular medical and dental check-ups is one of the best ways to stay healthy and to take care of small issues before they become big and expensive issues.

If the form shows you may be eligible, share a little more info and we’ll be glad to contact you directly!
Ready to sign up for care? Print the Eligibility Packet here.

While this form does not guarantee eligibility for the HELP Clinics, it is intended to inform whether or not you may be eligible. Eligibility can only determined after all paperwork is received and reviewed.

 
 

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