Eligibility Requirements

DOCUMENTS REQUIRED FOR ELIGIBILITY DETERMINATION

In order to receive certain services at Florida Department of Health Jackson you must be financially screened.

                                 You may elect to pay full fee instead of going through our eligibility screening process

Please bring the following items with you:

•  Identification Card (picture ID preferred), other examples are voter registration card, birth certificate, infant hospital records, paycheck stub, passport, etc.

•  Proof of residency(utility bill – electric or phone bill, bank statement, school record, recent driver’s license, foster child placement letter/notice, housing rent/mortgage agreement, US Military orders,    paycheck/stub with name and address, shelter letter signed/dated by staff, property tax receipt, W-2 form for previous year, unemployment documents in applicant’s or client’s name, voter registration card or letter from person applicant lives with and proof (such as utility bill, etc. with the name/address of individual with whom the applicant or client is living)

•  Social Security Card

•  Any insurance card(s)

•  Four (4) weeks most current/consecutive pay stubs:

    ◦If recently terminated – final paycheck or statement on letterhead stating you are no longer employed at company
    ◦If unemployed – copy of unemployment income statement, food stamp statement, SSI statement, and retirement statements, etc.