Scotland Community Health Clinic - Patient Application Information

The primary mission of Scotland Community Health Clinic is to provide quality health care to uninsured adult residents of Scotland County.

Applications must be picked-up in person at Scotland Community Health Clinic during clinic hours, Monday through Friday, 8 a.m. to 1 p.m.

Applications are reviewed inthin two business days. Applications that are incomplete or do not include all the necessary verifications are placed on hold or returned to the patient. Once the application is complete and has been approved, the patient will be notified to make their first appointment. Appointments for new patients are limited to four per week and are scheduled on a first-come, first-called basis.

DOWNLOAD AN
APPLICATION HERE

A current picture ID - driver’s license, State-issued ID, or a letter from a utility company with your Scotland County address.
Your Social Security number.
A copy of the latest tax return that you, your spouse, or anyone else living in your household filed.
A Statement of Zero Income form
Paycheck stubs for the last month or a letter from your employer for yourself, your spouse, or others in your household.
Verification (forms or letters) that you, your spouse, or anyone in your household receives or has been denied any of the following:
      1) Unemployment
      2) Social Security
      3) Retirement Income
      4) WFFA
      5) Food Stamps
      6) Private health insurance
      7) Other sources of income or support

A letter from the person(s) or organization who provides for your food, rent, shelter, and living expenses.
The names and ages of everyone who currently lives in your household.
Your total monthly household income
A list of the doctors you have seen.
A list of all your current medical conditions or complaints
A list of all your current medicines
A list of allergies to medicines
The name and phone number of someone ither than the patient that the clinic can call if there is an emergency.

✓APPLICATION CHECKLIST

When you apply for clinic services, we will ask for the following information and documents. If you do not understand anything on this list, we will help you. (Verification means that you have a letter, a form, or other proof of information.)

Scotland Community Health Clinic offers the following services:
   • Primary Medical Care
   • Medication Assistance Program
To qualify for services, patients must be:
   • Age 18-64
   • Residents of Scotland County
   • Have no health insurance
   • Low-income or no-income

PLEASE NOTE!
We do not provide medication assistance for narcotics or controlled substances.

Scotland Community Health Clinic gratefully acknowledges the support of Scotland County United Way
and the generous gifts and volunterism of numerous community individuals.

Scotland Community Health Care Clinic
1405-B West Blvd. Laurinburg NC 28352 | (910) 276-9912 | schc@schclinic.org