Become A Patient
Good Health Clinic is a private not-for-profit dedicated to providing healthcare for those in need. Funding is provided by grants and individual donors. In order to receive care at the Good Health Clinic individuals must fill out an application to determine if they meet the eligibility requirements. Accepted applications are valid for 1 year, after which patients must re-apply.
Patient Eligibility Requirements
1. Must be resident of the Florida Keys.
2. Meet gross income eligibility criteria. (see table below)
3. No health insurance of any kind.
For questions, contact a Good Health Clinic Patient Care Coordinator.
Patient Applications
To apply, please print and complete the patient application below. Submit completed forms along with the additional required documents listed. Applications may be dropped off in-person or submitted by fax or email.
Required Documents
Upon review, additional documents may be required.
1. Completed Application
(A separate application for each household member seeking services)
2. Identification
(Driver License, State ID, passport, etc.)
3. Proof of Address
(Provide ONE of the below IF your ID does not have a current address)
- Deed or current mortgage statement
- Copy of current lease — OR — NOTARIZED* letter from landlord stating address and monthly rent
- 2 pieces of official mail (from bank, utility company, government agency, etc.)
- If you are homeless, speak to the Good Health Care Clinic Staff
4. Proof of Income
(Provide ALL of the below)
- Current Income Tax Return for all adult members of your home
- If you did not file taxes, provide a NOTARIZED* letter stating you did not file taxes and are not claimed as a dependent
- If you are a dependent, provide Tax Return of your financial supporter
- Most recent month of pay stubs from all employers
- If you are paid in cash, provide a NOTARIZED* letter stating income per month and services you are paid for
- Documentation for all social services or government income you receive
(social security, welfare, SNAP, etc.)
Gross Income Eligibility Criteria
We encourage all patients in need with incomes near or below the listed totals to apply or speak with a Patient Care Coordinator. Social Security Income (SSI) is not counted toward totals.
| Family Size | Average Monthly Income |
| 1 | $3,765 |
| 2 | $5,110 |
| 3 | $6,455 |
| 4 | $7,800 |
| 5 | $9,145 |
| 6 | $10,490 |
| 7 | $11,835 |
| 8 | $13,180 |
| 9 | $14,525 |
For each additional person add $1,345 to the monthly income totals.