Patient Information

Health Care Access Clinic offers the following services to its clients. A modest fee of $10 – $20 is requested, but no one is denied care due to inability to pay.

Primary Care Clinic

Health Care Access Clinic offers a primary care clinic to meet the needs of our clients. The clinic is staffed by an Advanced Registered Nurse Practitioner (ARNP) who operates under the direction of the volunteer Medical Director, David Goering, MD.

Volunteer Provider Clinic

Local Doctors, Nurse Practitioners, and Physician Assistants donate their time and services by coming to the clinic and seeing patients. These appointments are often used by the clients who have a medical condition that needs consultation from a physician. A patient will usually be seen by an ARNP prior to a visit with the volunteer doctors.

Establishing Care

If you meet our eligibility guidelines, download and fill out the 3 forms listed below.  You will need to bring this paperwork with you to the clinic along with proof of income (eg. paystub [2 if paid bi-weekly], unemployment acceptance letter, social security benefits acceptance letter) and proof of residence (photo ID, utility bill or lease agreement preferred).  Once the completed paperwork and documentation is received the office staff can schedule an appointment to establish care with the nurse practitioner.
Patient Application – English/Spanish
Consent to Treat Form – English/Spanish
HIPPA Form – English/Spanish

Do I Qualify?

To qualify for services through Health Care Access Clinic each person must:

  • have a gross monthly income of no more than 185% of Poverty Level (click here)
  • not have any type of health insurance or resource (e.g. Haskell Indian Health Services, Veteran’s benefits, Medicaid, Medicare, Watkins Student Health Services)
  • be a Douglas County resident


When a patient needs services from a specialist, they can be referred by Health Care Access Clinic for a one time consultation with a specialist in the community who volunteers their time and service. This consultation is donated; however follow-up arrangements must be made between the client and the specialist.

Medication Assistance Program

Health Care Access Clinic realizes that if a person has limited means and/or low income and is unable to afford health care, they are most likely unable to afford medications. The medication assistance is limited to Health Care Access Clinic clients and the prescriptions that they receive through our clinic or through a referral specialist.

There are three different options for medication assistance:

  • Patient Assistance Program – Many of the pharmaceutical companies offer medications to the low income free of charge if they meet low-income criteria. Health Care Access Clinic clients meet the eligibility requirements of the major pharmaceutical companies. Our Staff assists each client in receiving medications through this program if available.
  • Samples – Pharmaceutical companies distribute samples of various medications to doctors’ offices on a regular basis. The physicians will donate portions of their samples to us for use by the Health Care Access Clinic consumer.
  • Discount Vouchers – Discounts are available at participating pharmacies with issued vouchers. The Clinic’s ability to pay for prescriptions is based on the available funds.

If you are a Health Care Access Clinic patient, please take a few minutes to fill out our patient satisfaction survey.  All results are anonymous and will be used to improve and expand our services in the future.  We are here to serve YOU and your feedback is vital in helping us serve you better in the future!