Patient Qualification

We know how hard it is to be without medical or dental care. That's why we're here. The Rapha Clinic of West Georgia is a charitable, faith-based, non-profit medical and dental clinic serving the West Georgia area. We serve patients who live in Carroll, Douglas, Haralson, Paulding, and Heard counties. We provide services to uninsured adults who are at or below 200% of the federal poverty level.

To qualify as a patient, you must bring the following information to a

Financial Screening at one of the posted times and locations listed at the

bottom of this page: 

1. Picture ID

2. Social Security Card

3. Proof of income for everyone in the household, totaling one month.

This includes unemployment, disability, social security, etc. Bring the award letter or if direct deposit, bring a copy of bank statement showing the deposit.

4. Proof of Food Stamps (bring the award letter)

5. Proof of Residency

(a utility bill or bring a letter from the responsible person if the utilities are in someone else's name.

6. Medicaid Denial Letter

(You must go to the Department of Family and Children Services in your county and apply for Medicaid. Even if you do not qualify, we must have a Medicaid Denial Letter, which will be mailed to you after applying.

7. Last Year's Tax Return (if you filed)

8. List of ALL Medication(s) and Dosages(s)

Financial Screening Location & Times

Temple Clinic

253 East Highway 78, Temple, GA 30179

Phone: 770-562-4501

Hours of Operation:

8:30 to 4:00 Tuesdays

8:30 to 3:00 Wednesday & Thursday

Appointments scheduled for any other time.

Financial Screenings:
Tuesdays, 2:00 PM – 4:00 PM

Directions to The Temple Clinic:

  • From I-20, take exit 19 and turn north.

  • Go approximately 1.5 miles until Hwy 113 and Hwy 78 intersect.

  • Turn right on Hwy 78 and go approximately .4 mile.

  • The Clinic is on your right.

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©2019  Rapha Clinic of West Georgia         Proudly created by Rhythm Communications