How to Become a Patient at DEAC
***DEAC is not a walk-in clinic***
An appointment will be scheduled after completing an interview to determine eligibility. Contact the Community Care Center at (336) 723-7904 if you have any questions.
To be eligible:
- Live in Forsyth, Stokes, or Davie county
- You cannot be eligible for state or federal sponsored healthcare insurance, including Veterans Administration, Medicaid, or Medicare.
- You cannot be eligible for healthcare insurance through your employer unless your contribution for individual coverage would exceed $150 a month.
- Becoming a patient first requires a financial screening interview. These are held every Tuesday and Wednesday from 1:30pm - 5:00pm. No appointment is needed for the interview. After the interview you will be scheduled for a medical appointment as soon as possible.
- Please bring these items to the interview:
- Proof of Identity
- Proof of Address (choose one)
- NC Driver's license, learner's permit, or state issued ID
- Current utility bill with name and address
- Bank statement with name and address
- NC voter registration card
- Current Social Services check or letter
- Current County/City billing statement
- Lease agreement or mortgage statement with the address of the residence, your name and your landlord's name and address
- Pay stubs with your name and address.
- If you are homeless, your shelter must give us a letter, on letterhead, stating that you stay there
- Proof of Expenses (please provide all that apply)
- Title, car registration or monthly bill for every car in the household.
- A lease contract for apartment or house.
- A mortgage statement or title for house.
- Monthly bills, including power, cable, telephone, credit cards, car insurance, etc
- Proof of Income (please provide all that apply)
- You are required to bring a copy of your last year's tax returns unless you did not file this form. However, please notice that in some cases the screener might ask you to obtain a letter from the IRS verifying that you did not file taxes the previous year. Also note that some patients may be asked to provide a health care insurance verification form from your employer.
- Please bring the following additional information as the specific situation applies to each member of the household (please read important definitions section):
- HealthCare Access (formerly Doctors Care) identification card.
- A letter from a homeless shelter on letterhead stating your name and dates of residency.
- Copy of the last two pay stubs from every person who works in the household (please read important definitions section to know whose pay stubs you are required to bring).
- Proof of disability or retirement benefits (letter from SSI). If you have direct deposit for these checks, you must provide a bank statement and verification from SSI.
- If you are paid in cash, a Verification of Employment Form, which you can obtain at our reception desk, must be completed, signed and faxed by your employer. We may call your employer to verify your information.
- If you are self-employed and do not file tax returns, bring your accounting books or a record of state tax sales revenue for the past year.
- If you are being supported by relatives or friends, we require a letter of support from the person who is helping you along with proof of her/his income to verify that they have enough income to support you.
- If you are being supported by an organization, we require a letter from the organization helping you on letterhead.
- If you are recently unemployed, bring your last two pay stubs and information about any unemployment compensation you will be receiving.
- If you are living on savings, you must provide three of your most recent bank statements.
- Additional Information for Children (please bring all of the following)
- Vaccination record
- Medicaid card (if your child is on Medicaid)
- Ages 5 -17 –school records with current address
- Household: Defined asmembers of an immediate family living in the same residence. This includes parents, son, daughters, grandparents and children for whom the parents have legal custody. Children living in the same household as their parents, regardless of age, will be considered part of the household. Children who do not live with their parents may be included on an application if the parent can show that they support the child financially.
- Proof of identity must be provided for each member of the household (including children) listed on the application. Others living in the house or apartment, such as sisters, brothers, aunts, uncles or friends must apply separately.
- Individual: A single person who lives alone or resides with others but does not qualify as a member of a household.
- Emancipated child: An individual 18 years of age or under who is unmarried and lives on their own without financial support from parents may apply as an individual.
Community Resources outside of DEAC:
Community Care Center is a free medical and dental clinic separate from DEAC and operated mostly by volunteer physicians and staff. The CCC opened in 2000 and has grown to become the largest and most comprehensive free clinic in North Carolina.
Forsyth County Department of Public Health website provides educational information about healthy well being as well as information on services provided.