Southern Jersey Family Medical Centers participates in many federal and state-funded programs, including those that provide services to the uninsured and to others on a sliding-fee scale, based on an individual’s or family’s ability to pay. Many of these publicly funded programs require that patients register for services and provide information to verify their identification, income and dependents. Based on the information provided, a patient’s eligibility for services and payment level is determined.

In addition, the registration information provides the basis for contacting patients and families in case of a medical emergency, abnormal clinical laboratory tests, notification of new services, and changes in operation hours.

Prior to your first visit to a Southern Jersey Family Medical Center, you should review
the information below and bring the proper documentation to ensure that you can be properly registered for care.

Proof of Personal Identification:

• Driver’s License
• Social Security Card
• Immigration Registry Card
• Birth Certificate
• Employee Identification Card
• Elective Service Card
• Union Membership Card
• Voter Registration Card
• School Picture Identification Card

Proof of Residence:

• Mortgage Invoice/Coupon
• Rent Book/Lease
• Utility Bill
• SJFMC Signed Support Form by Person Providing Assistance

Proof of Household Income:

• Paycheck or Stub
• Unemployment Check Stub
• Disability Check Stub
• Social Security Award Letter/Copy of Check
• Child Support Check Stub
• Alimony Payment
• Most Recent Income Tax Return
• Statement of Foster Child Care Benefits
• Employer Signed Statement
• If no income, a signed SJFMC Form from the person providing support is required