HIV Clinic Services

Enrollment Eligibility

Clinic Operations receives Ryan White Part C federal funds to provide medical care for persons with HIV/AIDS. These funds are intended for the uninsured client who does not qualify for any other medical resources. We do not accept private insurance. However, if you have Inland Empire Health Plan (IEHP), a current referral from a primary care provider is required. In order to provide services to members of our community, we must ensure that the clients we serve fulfill residency and income eligibility requirements.

Client Information Needed

The following information must be obtained before the first visit and periodically thereafter. This information must be obtained from all new and established patients. The registration and/or scheduling process will be expedited by bringing copies of the required documents and filling out the forms before you arrive to the clinic.
Support Affidavit
Self Employment Affidavit

Information To Bring

• Proof of Diagnosis
• Income Verification (one or more of the following is required):
  • Three (3) current paycheck stubs
  • Three (3) current bank statements
  • SSI or SSDI letter
  • MISP/CMSP letter
  • Letter from some other form of government assistance (Medi-Cal, MISP, CMSP card preferable).
• Residency Verification (we need two of the following):
  • Current utility bill (gas, water, electric)
  • Current rental or lease agreement and last month’s rent receipt
  • Voter registration

• Insurance Verification
  • All new and established patients will be referred to apply for Medi-Cal and/or Covered CA. Proof of enrollment or denial of eligibility is required.
• Current Picture ID (one or more of the following is required):
  • Driver’s License
  • Immigration Card (Matricula Consular)
  • United States Passport