Patient Eligibility Requirements

To become a patient, you must be uninsured, meet income eligibility guidelines, and provide the required documentation. *

Uninsured
• The application includes a section where you will attest that you do not currently have health insurance (for example: Medicare, TennCare, TRICARE, or commercial insurance).

Proof of Income (Please provide one of the following)
• Most recent 1040 tax return
• Most recent pay stubs (minimum of 3)
• Letter from employer
• Disability or Social Security benefit letter

Photo Identification (Please provide one of the following)
• State-issued driver’s license
• Passport
• Any other government-issued photo ID

Proof of Address (Please provide one of the following.  It must match the address on your application)
• Most recent 1040 tax return
• A recent piece of mail with your current address

Proof of Number of People in Household (Please provide one of the following)
• Most recent 1040 tax return listing all household members
• Social Security cards for household members not listed on the tax return

In most cases, a 1040 tax form provides much of the information needed to determine eligibility. It is also required for many of the medication assistance programs we use to help patients access prescriptions.

If you have questions about eligibility requirements or documentation, please call us at 865-546-7330.

*Patients must be 6 years of age or older.