Fauquier Free Clinic
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Eligibility
Patient Forms
Volunteer
Donate
News & Events
Charity Golf Tournament
Give Local Piedmont
Rappahannock Rough Ride
Expanded Care Plan
About Us
VHCF Dental Expansion Report
Strategic Plan
Meet Our Dental Team
Contact Us
Hours & Location
History
2025 Annual Report
2024 Annual Report
2023 Annual Report
Prepare for your Visit!
Before you arrive for your appointment or walk-in...
1) Please read the
ELIGIBILITY
page on our website
2) Collect the documents needed for your eligibility screening
3) Fill our our patient forms
below
to prepare for your visit
We look forward to serving you!
Welcome Letter
CARTA - BIENVENIDOS A LA CLINICA
Privacy Practices
AVISOS de PRIVACIDAD
Release of Information Form
BLANK ELIGIBILITY FORMS YOU MAY NEED
Below are blank forms that may apply to you as a patient.
Please speak with the clinic to start the process.
Cash Income Statement
Declaracion De Ingresos Ganados En Efectivo
Income - Expense Ledger
Registro de Contabilidad
Letter of Support
Carta De Apoyo
Verification of Employment
Verificacion De Empleo
Home
Patients
Services
Eligibility
Patient Forms
Volunteer
Donate
News & Events
Charity Golf Tournament
Give Local Piedmont
Rappahannock Rough Ride
Expanded Care Plan
About Us
VHCF Dental Expansion Report
Strategic Plan
Meet Our Dental Team
Contact Us
Hours & Location
History
2025 Annual Report
2024 Annual Report
2023 Annual Report