Submit a new provider

Does your organization provide health services to the uninsured?  Please submit your information to be included on this website.

All fields are required unless otherwise noted.

- Please provide the parent organization, followed by the clinic site. (e.g. Native American Health Center -- Oakland Seven Directions; LifeLong Medical Care -- Downtown Oakland Clinic)

(optional)


- If applicable, the phone number for new patients to call.
- The phone number at this site for existing patient to make appointments.
(optional)
Ages - Age range served at this particular clinic site.
    Languages - Please check those languages in which medical providers speak or in-person or VMI interpreters are available. If language line is available for other languages, please just check the “language line” box.
      (optional)
      - Please fill in below your hours of operations. If you have any notes or exceptions, please indicate in the box below. (e.g. closed the first Wednesday of every month from 9-12)
      (optional) - This section intended to walk uninsured people (who are new to the safety-net system) through the process of receiving services. At some clinics, this would be a section to explain the eligibility process (how to become a member at a clinic, what to documents to bring, what to expect). At clinics that have urgent care or drop-in hours, this section could explain procedures on when to arrive, etc.
      Insurance and Coverage Programs Accepted (optional) - Please check all that apply.
        (optional)
        (optional) - Please indicate your payment policies here. If the clinic operates a sliding fee scale, please indicate here. Clinics have the discretion of generally indicating the cost of services, or of giving a price range for the costs of care. If you are a free clinic, please indicate services are free.
        (optional) - Please indicate any information that you feel would be useful to new patients regarding the availability of appointments. If you operate a drop-in or urgent care clinic, please indicate here, along with policies for drop-in (e.g. we accept the first 10 drop-ins that arrive at 5:00 P.M.).
        Services Offered - Please check those services that are available at this specific site.
          (optional) - This is an open section in which your clinic can provide any additional information that you feel would be of assistance. If your clinic provides additional services not mentioned in the check boxes above, please indicate here. If your clinic targets a specific population (e.g. students of a high school, re-entry population, day laborer population) please indicate here.
          - Please provide contact information. This will not be published. This is for the ACHealthCare.org staff, if they have questions about the site's services.