Alabama Free Clinic is a 501(c)(3) Tax-Exempt Organization 

Our Mission is to improve the overall health of Baldwin County by providing no-charge medical care and health education programs for adults who are without medical insurance.

****We are not a walk-in clinic.  You must complete an application and screening process.****

 

 

Patient Application

Thank you for your interest in being a patient at Alabama Free Clinic!

 
Patients are seen by appointment only; no walk-ins are accepted. 
 
To Become a Patient:
  • Call the clinic office at (251) 937-8096
  • Complete a phone screening
  • Provide requested documents (see below)
 
To expedite your approval and care, please PRINT the form below, and upload a copy of these required documents:
  • Photo ID
  • Social Security Card
  • Proof of Income
  • Proof of Residency (lease, utility bill: gas, water, electric bill)
 
You may download the application here and mail your required documents to:
Alabama Free Clinic
P.O. Box 1284
212 Courthouse Square
Bay Minette, AL 36507
 NEW FAX NUMBER: 251-580-3140
 
 
When filling out the digital form below, you MUST attach all 4 required documents before the form will Submit***
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