West End Medical Centers, Inc. is partially funded by the Department of Health and Human Services. These federal funds allow us to offer a Sliding Fee Scale Program to patients who qualify. To apply for the Sliding Fee Scale Program, patients must supply required documentation; including valid photo identification, proof of income for the past 30 days and current address verification. Patients must be re-certified every six months or sooner.
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What is considered valid photo identification?
One of the following:
- Drivers License
- Passport
- Current College ID Card
- U.S. State-Issued ID Card
- U.S. Immigration Photo ID Card
- Military ID Card
- Foreign ID Card
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What is considered valid proof of income?
One of the following:
- Income Tax W2 Form
- Check stub(s) from employer equaling the last 30 days of employment
- Current Food Stamp Summary Notification Sheet*
- Disability/Worker's Compensation Notification Form*
- Medicaid/Medicare Form or Card*
- Social Security Notification Form*
- Pension/Retirement Statement*
- Unemployment Eligibility Sheet*, Checks or Check Stubs
- Veteran's Benefit Statement*
- Child Support Court Award*, Receipts or Checks
- Official Documentations from another Social Services Agency
- Form W615 from the Georgia Department of Labor*
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Full/Part-Time Undergraduate or Graduate Students:
One of the following:
- Financial Aid Statement*
- Work Study Notification*
- Verification of Parents' Income
* MUST INCLUDE AMOUNT OF FINANCIAL BENEFITS |
