Eligibility Form

At Community Health, we offer health and dental services to those uninsured or underinsured.
Heal the sick is a vital part of our ongoing mission.

Patient Information

To become a patient at the medical and/or dental clinic you need to complete the eligibility application. The medical and dental clinic use the same application. Once completed, submitted, and approved your appointment can be made. 

When you come to the clinic please call the number located on the door. Covid-19 protocols are in place and patients can’t walk in. When you are brought in you will need to wear a mask, have your temperature recorded, and answer Covid-19 symptom questions.

We look forward to serving you at Community Health Outreach.

New Patient? Walk in prepared.

Download the required eligibility form here; fill them out and bring them by for your appointment.