Spanish-language materials and interpreters were made available to Clinic Latino patients in the year 2000. These additions facilitate clear and accurate communication between Latino clients and Clinic employees.

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Patient Info
What to Bring

Information required to be a patient at the Tippecanoe Community Health Clinic.

Proof of identity:

  • Photo ID
  • Social Security Card
  • Passport
  • Green Card
  • Residency Card
*If you have not been issued a valid social security card, please do not present one.

Proof of mailing address:

  • Copy of utility bill, telephone bill, credit card statement, or bank statement
  • Correspondence from employer, Social Security Administration, Medicaid, Veterans Administration, etc.
  • Copy of rental or lease agreement

*If your name is not on the document, the addressee must indicate in writing that you receive mail at that address.

**An address written on a piece of paper is not acceptable.

We must have an emergency or message contact name and phone number. We must be able to reach you.

Proof of current income:

  • The 2 most recent pay stubs or letter from employer stating number of hours worked and rate of pay. This includes unemployment checks.
  • Letter from Social Security Administration, Veterans Administration, Medicaid (TANF), or any other agency from which a benefit is received showing the monthly allowance. If this is directly deposited into a bank account, the most recent bank statement showing the deposit is acceptable.
  • The most recent tax return if you are self-employed.
  • If you have no current income, a written statement from the person providing assistance to you must be brought in. The letter must be legible (can be in either English or Spanish), dated and signed. The name of the person providing assistance should also be clearly printed on the letter, along with a daytime telephone number.

*Proof must be presented for all immediate family members living in the household.

Insurance information, if applicable:
  • Medicaid/Hoosier Healthwise card
  • Medicare card
  • Insurance card
*Sorry, but we do not accept HMO, Blue Cross/Blue Shield or Anthem

All medications that you are currently taking (or supposed to be taking):

If you do not have the bottles or prescriptions, a list may be presented that has the medication name, dosage and physician who ordered the medication or pharmacy that filled the prescription.

All of the items above that apply to you must be brought in at the time of registration.
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