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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 2016 Federal Poverty Level Guidelines.
Registration/Eligibility is available:
Mornings: Tuesday thru Friday at 8:00 a.m.
- No appointment is necessary – However, the process is first come, first serve
- Only the first 25 applicants each day will be able to complete the eligibility process.
- At least two hours should be allotted for the process.
- Depending on the number of inquiries, the process could take more or less time.
To expedite the process, please print and fill out ALL the forms listed here and bring them with you.
- Patient Registration
- HIPPA Disclosure Consent Forms
- 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:
1) Proof of Income
- a paycheck stub
- a letter from your employer (on business letterhead including company name, address, and phone number)
- unemployment forms
- a notorized letter from the person who is financially responsible for the household
2) Identification Card
- driver’s license
- counselor card
- 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
3) Proof of Address
- phone bill, FPL bill
- car registration or insurance
- other recent document received in the mail with your name and address