Loudoun Free Clinic - Serving the Uninsured

Eligibility Interview

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Before individuals can be seen by health care professionals at the Loudoun Free Clinic, they must first make an appointment to determine if they meet eligibility requirements.  Eligibility interviews are conducted during office hours on weekdays. 

 

Please call 703-779-5416 to make an appointment.

Once an appointment is scheduled, individuals must bring the following documents to the eligibility interview:

Proof of Residency:

  • Driver's license 
  • DMV ID card 
  • Lease/Mortgage
  • Utility bill
  • Letter from shelter
  • Official postmarked mail

Proof of Income:

  • Pay check stubs (2 or 3 most recent) 
  • Most recent tax return or W-2
  • Letter from employer, on letterhead if possible
  • Benefits letter (food stamps, TANF, unemployment, etc.)
  • Bank statements (2 months)

 

 

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    224-B Cornwall Street  *  Leesburg, Virginia 20175  *  703.779.5416
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