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HAWC Main

Medical/Dental Clinic
1055 South Wells Ave.
Reno NV 89502
____________
Phone
775 329-6300
Fax
775 329-7253

HAWC Outreach Medical Clinic

335 Record Street, Suite 250

Reno, NV  89512

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Phone

775-324-2599

Fax

775-324-0724

 

HAWC Storey County Health Center

175 E Carson Street

Virginia City, NV 89440

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Phone

775-284-3570

Fax

775-284-3599

HAWC Administration Office

1450 Ridgeview Drive, Ste 200

Reno, NV 89519

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Phone

775-329-6300

Fax

775-348-3896

 

Sliding Fee Eligibility Checklist

*** Links to forms are at the bottom of this page ***

Click here to see the sliding fee scale

Note to patients applying for sliding fee: eligibility is based on your gross annual income and the size of your family.

 

Para pacientes applicando para el descuento de bajos recursos: La calificacion es basada en sus ingresos anuales y cuantos miembros hay en la familia.

 

1.      Government issued identification card of the head of household.

Una identificación del gobierno de la persona responsable.

 

2.      Proof of address.  A current utility bill, rent agreement or lease (see Proof of Address documents list) with the name and address of the head of household.

Prueba de su domicilio.  Cualquier cobro de utilidades, contrato de rentamiento o de alquiler con el nombre y la dirección de la persona responsable.

 

3.      Proof of income.  The following may be used to prove gross annual income

(calculated from the past 3 months):

 

Prueba de salario.  Los siguiente se puede usar como comprobante de

su salario anual (calculado de últimos 3 meces):

 

Paycheck Stubs (three most current)

Talones de cheques (tres mas reciente)

Social Security Determination Letter

Carta de pensión del seguro social

Unemployment determination letter

Carta de desempleo

 

 

To complete your Sliding Scale Fee Application, it is best to make an appointment with our eligibility specialist in Suite 100. You may schedule this appointment by calling 329-6300 option 3.  Please direct question about sliding fee eligibility to 329-6300 x168 or x169. Thank you.

 

Para completar su applicacion de bajos recursos, es major que hagas una cita para entregar sus documentos en la oficina cuarto #100. Para una cita llame al telefono 329-6300 opcion 3. Si tienes preguntas llamar al 329-6300 x168 0 x169. Gracias.




 

PDF Documents:

Application Directions

Proof of Address Documents

Application Procedure - English / Spanish

Application Form - English / Spanish

 

 

 

 

 

     
 

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