For Prospective Patients

If you are working and do not have health insurance, Good Samaritan Clinic is here to help you.

Here is a summary of our patient eligibility criteria:

  1. Persons who have Medicare, Medicaid, Worker’s Compensation, or private health insurance are NOT eligible for services offered by the Good Samaritan Clinic.
  2. Your household income must fall within the Clinic’s income guidelines.
  3. You must be employed or self-employed (if over the age of 18).

Exceptions to the “employed” criteria:

  • Full-time student
  • Parent with children under age 6
  • Those who have been unemployed for less than six months and are actively seeking employment
  • The homeless
  • Persons under 18

Fees are on a sliding scale based on income. The maximum any patient will be asked to pay is $35 per visit. The average charge is $5 to $7.

If you want to register as a GSC patient, you may print the following forms or pick them up at the Clinic:

To register and qualify as a GSC patient, you must have a photo ID, proof of income (check stubs, IRS tax return or letter from employer), and proof of Arkansas or Oklahoma residence — as well as the completed Patient Information Form. Please bring these items to the Clinic with you to begin the registration process.

If you have questions about your eligibility, our fee structure and/or payment requirements, please call the Clinic at 479-783-0233.