Expedite your visit
In order to receive certain services from the The Florida Department of Health in Alachua County you must be financially screened. Please bring the following items to with you:
- Identification Card (picture ID preferred, other examples are voter registration card, birth certificate, infant hospital records, paycheck/stub, passport, etc.
- Proof of residency (utility bill - electric or phone bill, bank statement, school record, recent driver's license, foster child placement letter/notice, housing rent/mortgage agreement, U.S. Military orders, paycheck/stub with name and address, shelter letter signed/dated by staff, property tax receipt, W-2 form for the previous year, unemployment documents in applicant's or client's name, voter registration card or letter from person applicant lives with and proof (such as utility bill, etc. with the name/address of the individual with whom the applicant or client is living)
- Social Security card
- Any insurance card(s)
- Eight (8) weeks most current/consecutive pay stubs:
- If recently terminated - final paycheck or statement on letterhead stating you are no longer employed at company.
- If unemployed - copy of unemployment income statement, food stamp statement, SSI statement, retirement statements, etc.
- No income - bring a notarized letter from whoever is paying room and board, or have responsible party come in with you and sign letter here.
In order to expedite your visit and provide the fastest service possible, please fill out the following forms:
- Demographic Form for Adult
- Demographic Form for Adult (Spanish)
- Demographic Form for Child
- Demographic Form for Child (Spanish)
- Medical Service Authorization
- Medical Service Authorization (Spanish)
- Initiation of Services Form
- Initiation of Services Form (Spanish)
- Client Billing Changes
- Client Billing Changes (Spanish)
- WIC Guidelines