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New Patients: Text
NEW PATIENTS
All are welcome at the Blue Ridge Free Clinic!
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Don't have insurance and not eligible for Medicaid? We'll see you.
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Don't have insurance and eligible for Medicaid? We'll help you get signed up.
New Patients: Text
New Patients: Contact
NEW PATIENT APPLICATION FORM
Complete this brief form and someone from the clinic will get back to you within 2 business days.
Important! Before your first visit, please download and print these THREE forms. Bring the completed forms with you to save time!
Eligibility Criteria
(for free pharmacy and ancillary services (labs, X-rays, specialty care) through Sentara RMH Medical Center))
Family Size
Annual Income
$45,180
$61,320
$77,460
$93,600
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