Atrium Health Wake Forest Baptist DEAC (Delivering Equal Access to Care) Clinic

DEAC is not a walk-in clinic.

DEAC is a free clinic for those who cannot afford health insurance and do not qualify for government assistance. Prospective patients must undergo financial screening and meet the following requirements:

• Have an income within 200% of the Federal Poverty Guidelines
• Not have medical coverage of any kind, and
• Be a resident of Forsyth, Stokes, Davie, Davidson or Yadkin county (for at least 90 days)

You may also be asked to provide proof of expenses and proof of income. Proof of expenses could include:

• Title, car registration or monthly bill for every car in the household
• A lease contract for an apartment or house or a mortgage statement or title for a house
• Monthly bills, including power, cable, telephone, credit cards, car insurance, etc.

For proof of income, you are required to bring a copy of your last year's tax return unless you did not file, in which case you may be asked to obtain a letter from the IRS verifying that you did not file taxes for the previous year.

You may be asked to provide a health care insurance verification form from your employer.

Each member of your household may be required to provide:

• 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. This 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.

Household

• Members 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 parents 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.