Eligibility
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Caridad Center provides comprehensive health services to UNINSURED children and adults who live in Palm Beach County and are at or below the 200% federal poverty level. Applicants must first go through the Registration/Eligibility Process before making an appointment at the Clinic. To see if you qualify please check the guidelines:
Federal Poverty Level Guidelines 2020
Registration/Eligibility is available:
Monday thru Saturday from 8:00 a.m. to 12:00 pm
By appointment only – for appointments please call 561-737-6336 Ext 126.
Patient Registration
HIPPA Authorization for Non-Routine Disclosure
HIPPA Non-Discrimination & Grievance Form
HIPPA Non-Discrimination & Grievance Form (Spanish)
Medical Patient History
Treatment Consent Form
All applicants must provide these three (3) items:
Proof of Income
Examples:
- a paycheck stub
- a letter from your employer (on business letterhead including company name, address, and phone number)
- unemployment forms
- a notarized letter from the person who is financially responsible for the household
Identification Card
Examples:
- driver’s license
- counselor card
- passport
- other recent I.D. with name and photo
Please note: Minors under the age of 18 must:
- be accompanied by a parent or legal guardian
- bring a copy of their birth certificate
Proof of Address
Examples:
- phone bill, FPL bill
- car registration or insurance
- other recent document received in the mail with your name and address
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