Patient Enrollment

Patient enrollment is available every day.

Call 330.764.9300

Patient enrollment is available every day. Remember to include your name and daytime phone number. Calls will be returned within one business day.
Patient Enrollment Form

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Eligibility Requirements

To be eligible to receive free care, applicants must:

  • Be 18-64 years of age
  • Have no health insurance, or a high deductible
  • Receive no government medical care or aid such as Medicaid or Medicare
  • Be working and have have an income level that is within 250% of the federal poverty level
  • Live in Medina County
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