Discounted Services

First Choice Primary Care offers a Discount Fee Program for eligible uninsured patients based on your household size and gross household income. Under this program co-pays can be as low as $45.00 for the first visit and $35.00 for each visits thereafter.

In addition to completing the program application below, you will need to present a current driver’s license or other state issued photo identification card upon arrival.


Click to Download Application

You will also need to provide documented proof of your household size and all income anyone in your household receives.  (You must include retirement benefits, pensions, unemployment, strike benefits, workers compensation, alimony and child support, interest, dividends, insurance payments, self-employment, rental income, royalties, training stipends, scholarships, military allotments, AFDC, TANF, SSI and any other type of income.)

The following documents are acceptable proof of income under this program:

  • Utility Bills or other mail listing your current address (2 needed)
  • The most recent pay stubs (2 needed) for each working member of your household
  • Most recent W2
  • Wage inquiry form
  • Copy of tax return
  • Statement on employer letterhead stating average hours worked a week and the pay rate
  • Proof of child support income
  • Current award letter or printout from the Social Security Administration
  • Proof of government assistance from DFACS

For patients without any income, we require one of the following documents:

  • IRS non-Filers statement
  • Most recent income tax return
  • Statement from the unemployment office
  • Termination letter from a recent employer
  • Verification of benefits from the DFACS office

Our policy requires that income information must be updated and verified at least once per year.

The following government agencies can help you locate many of the documents required.
Bibb County Unemployment Office:  3090 Mercer University Dr. (478-751-6164)
Social Security Office:  3530 Riverside Drive (478-477-7950)
Internal Revenue Service:  600 North Avenue (478-752-8243)
Bibb County Department of Family and Children’s Service; 456 Oglethorpe St. (478-751-6051)

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