NOTICE TO INDIVIDUALS:
This practice serves all individuals regardless of inability to pay. Discounts for essential services are offered based on family size and income. For more information, ask at the front desk. Thank you.
AVISO PARA PACIENTES:
Esta práctica sirve a todos los pacientes, independientemente de la incapacidad de pago. Descuentos para los servicios esenciales son ofrecidos dependiendo de tamaño de la familia y de los ingresos. Usted puede solicitar un descuento en la recepción. Gracias.
ACR uses a Sliding-Fee Scale to determine financial assistance “discounts” based on the family or individual’s income and family size. Sliding-fee discounts are based on the Federal Poverty Guidelines.
In order for a patient to participate in the Sliding-Fee Discount Program, the patient must complete the Sliding-Fee Discount Program application and provide required proof of income. It is the responsibility of the patient to provide the evidence of eligibility to participate in this program. To do so, patients should bring at least one of the following to the health center:
• Current year’s 1040 tax form
• A pay check stub
• An unemployment stub
• Statement of income from housing or food stamp program
If none of the above documents are available for review, other forms of verification may be accepted; patients should contact the Office Manager at their clinic for more information.
Questions? Please Give Us a Call!
If you have any additional questions or would like to sign up for the program, feel free to contact the Office Manager 404-508-0078 between 8:30 AM and 4:30 PM, Monday through Friday.