Sandhills Medical is committed to providing affordable, high-quality care to our community. Our Sliding Fee Discount Program reduces the cost of your care based on your household size and total household income compared to Federal Poverty Guidelines. All patients are encouraged to apply, regardless of insurance status.
Applying for this program is completely confidential. It will never affect your credit score or your immigration status.
Discounts are determined by household scaling. Depending on your approved tier, your visit will cost a flat nominal fee of $20, $30, $50, $60, $80, or $100. Patients who do not qualify for a discount or choose not to provide income verification will be responsible for the full charge of the visit.
You can apply in two ways:
Online: Download and print the Sliding Fee Form directly from our website.
In Person: Request and complete an application at the front desk of any clinic location.
To process your application, you must provide proof of your Gross Income (the amount before taxes are taken out) for the last 30 days. Please bring the document that matches your current situation:
| Income Source | Required Documentation |
| Paid Bi-Weekly | Your last 2 consecutive pay stubs. |
| Paid Weekly | Your last 4 consecutive pay stubs. |
| Paid by Letter | A letter from your employer on official company letterhead stating your current rate of pay and the hours worked (weekly, bi-weekly, or monthly). |
| Fixed Income | Your current year Award Letter for Social Security, Disability, or Public Assistance. |
| No Income | If you do not have personal income but receive support from friends or family, you must fill out our No Income Form at the clinic. |
If you have questions about the application process or need help figuring out which documents to bring, please call us at 866.737.4031.
Join our Patient Online Services hosted by FollowMyHealth! In order to connect to our Patient Online Services, you will need to receive a secure invite by email.
