New Patient Application | Acacia Medical Mission

We Are Accepting New Patients

Follow the three steps below to fill out the application.

1

Determine If You Qualify

Applicants must meet ALL of the following requirements:

1. Age

4 years old +

2. Employed

You must have a paid job OR have a household income and perform an important unpaid job, such as:

caregiver
volunteer
attend school

4. Residency

We serve residents of Comal and neighboring counties. Please provide proof of residency. Examples include lease, utility bill, etc.

3. Uninsured and underinsured
We DO NOT ACCEPT ANY insurance including Medicaid or Medicare. Underinsured residents must meet specific requirements. Please call the clinic for more information.

2

Complete Application

To become a new patient, you can visit the clinic to qualify in person during clinic hours. Send us a text at 830-251-4477 to request an application.

Fill out the forms below.

3

Prepare Your Documentation

If you apply online, you will need to bring ALL of the following documents to your first appointment:

Proof of Income (W2, 3 recent pay stubs, or tax return)
Photo ID
Proof of Address (water or electric bill)
Medications
Medical history and lab results (if available)
New Patient Forms

If you apply in person, you will need to bring ALL of the following documents to Admissions:

Proof of Income (W2, 3 recent pay stubs, or tax return)
Photo ID
Proof of Address (water or electric bill)
Medications
Medical history and lab results (if available
New Patient Forms

New Patient Forms

Select one

English

Spanish

Questions?

If you have any questions regarding this process or what to bring, please call our office: 830-228-4219

or email info@acaciamedicalmission.org