Patient Documentation

Patient Documentation

To receive services at Trinity Free Clinic, you must present the following documents when you arrive:

  1. A photo ID with your current address. All patients must present a photo ID without exception. Acceptable forms of photo ID include:

    • Valid driver’s license

    • Passport

    • School ID (for minors)

    • Indiana State ID card

    • If your photo ID does not have your current address, you must also provide one of the following:

      • Current utility bill or any other bill that shows you are a Hamilton County resident

      • Lease

      • Car registration

  2. Residency Documentation. Patients without proof of residency will be seen for acute illness only. Appointments for specialty services (for example eye and asthma) are not available to visitors. Acceptable forms of residency documentation include:

    • Valid driver’s license

    • Car registration

    • Pay stubs

    • Utility bill

    • Lease agreement

    • Letter for child’s school

    • Bank statement

  3. Income Verification. Since 2018, Trinity Free Clinic has asked for household income documentation as required by grants and donors. The clinic strives to serve patients who have an income that falls below 250% of the poverty level (see chart below). Please bring the following:

    • Current bank statement AND

    • 1 month of paycheck stubs

      1. OR letter of employment

      2. OR Social Security / Disability

      3. OR Child support documentation

      4. OR Copy of 2018 taxes / W-2

Please bring all documentation to your appointment. It can also be emailed to help@trinityfreeclinic.org or dropped off Monday - Thursday, 9 a.m. - 5 p.m.

Trinity Free Clinic Income Eligibility Guidelines

Your household income must fall below the amounts listed below
Number of people in household:Monthly income:
1$2,513
2$3,383
3$4,254
4$5,125
5$5,996
6$6,867
7$7,738
8$8,608