Sliding Fee Program

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Eligibility

Required documentation every six (6) months:

1. Proof of Identification (2)
   1. Picture ID
   2. Social Security Card
   3. Birth Certificate
   4. Current Bill
2. Proof of Income (Current)
   1. Federal tax return
   2. Month's pay stubs / social security / retirement checks
   3. Notarized wage statement from Employer
3. Proof of NO Income
   1. GA Department of Labor Wage Determination Letter
   2. Notarized statement from person providing your financial support

Apply Today

Schedule (as of Feb. 17, 2016)

LEVEL

A

B

C

D

​E

FEE

$20.00

$40.00

$60.00

$80.00

​$100.00

These prices DO NOT INCLUDE lab charges.

Dental minimum pay is $30.00.
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For information regarding our Sliding Fee Application, please contact our Patient Representative at 912-287-9140 ext. 118.