Registration Information

All patients are seen by appointment only.  We do not accept walk-ins.  If you are having a medical emergency, call 911.

Once you have qualified and registered, you will have the opportunity to make an appointment in the clinic.

Who can be a patient at ACHN?

  1. If you do not have medical insurance
  2. If your income level falls within 200% of the Federal Poverty Level, based on your household size.
  3. Adults and children who qualify for State benefits, such as:
  • Food Stamps (SNAP)
  • VA TANF (Temporary Assistance for Needy Families)
  • Section 8 Housing
  • Unemployment Benefits
  • School Free Lunch Program

If you meet the above criteria:

  1. Fill out the Registration Form
  2. Provide a government-issued Photo ID – passport, green card, driver’s license, state ID
  3. Provide proof of Income:
  • One of the following: Tax Return, W2 or 2 recent paycheck stubs
  • If no income, fill out this Zero Income Form
  • Documentation of other income including social security, disability, retirement/pension, child support/alimony, unemployment income.

Fax ALL of the above required documents to us at 888-965-5824 or bring it in person to the clinic during business hours.  Once we have received your completed registration packet, we will review it and contact you. Incomplete applications will not be processed.

We cannot accept any patient information via email.