Patient Information

We’re Here For You

Community Health Connect connects the low-income and uninsured in Utah County to donated medical and dental care. We work with several doctors and dentists who provide free and discounted care in their own office to our patients. If you need a Spanish speaking interpreter to attend your appointment with you, we have dedicated volunteers available to help. To qualify for our program, you must live in Utah County and be at 150% of the Federal Poverty Level or below according to your family size and income.

poverty guidelines1

To apply for our program, patients need to bring the following items into our office with their completed application:

  1. Referral from a primary care provider (medical only)
  2. Proof of income:
    • Most recent federal income tax return and W-2 form
    • Paystubs (at least most recent month)
    • Bank Statements (3 most recent months)
  3. Proof of Utah County Residency (utility bill, lease agreement, etc.)
  4. $20 Membership fee

     

TO DOWNLOAD AN APPLICATION & GET STARTED, CLICK THE BUTTON BELOW

Application in English

Contact Us



Our Office

Address
591 South State Street Provo, Utah 84606
Phone
(801) 818-3015
Fax
(801) 818-3020

 Office Hours

Monday
9am-6pm
Tuesday
9am-4pm
Wednesday
9am-6pm
Thursday
9am-4pm
Friday
closed

Closed for lunch each day 12pm-1pm



 Send Us a Message

We would love to hear from you.
Send us a message and we will get right back to you.