The uninsured who are working, disabled or those transitioning into work.  Patient can live or work in Coffee, Franklin, or Moore Counties of Tennessee or be a full-time student (12 hours of course work) and must be uninsured.  Patients who are on disability or in transition of work must be residents of Coffee, Franklin or Moore County.

If you do not work, documented proof of the following must be provided:
–Full time student status
–Disability income award letter stating income with no insurance benefits starts
–Patients in transition of work must gain employment within 6 months of receiving eligibility for clinic access.

Complete the online application below. The application along with the required documents listed below will be reviewed by staff and if requirements are met, you will be contacted to book your first appointment.

You will need to upload the following documents to complete the application. You may use your phone to capture the image or scan. Jpg or pdf formats are preferred.

–Three most recent pay stubs, W2 or 1040 if employed. 
–Metered mail such as a utility or phone bill
–Photo identification

*Additional information is required for student and disability categories.

–Live or work in Coffee, Franklin, or Moore Counties of Tennessee
–Someone in the household works 20 hours per week or is a dependent of someone who does. 
–Entire household income is at 250% of the current Federal Poverty Guideline or below.