Medical Care
Referral Services
Patient Support Services
Interpretation of Lab Work
Patient Prescription Services
Educational Seminars
Meet our Staff of Volunteers
Items Needed for the Application
PROOF OF IDENTITY
BRING ONE OF THE FOLLOWING:
Passport
Picture ID
Other Nationality Picture ID
(If ID does not have the current address, bring a recent utility bill with name on it or mail with your current postal address and name on it.)
PROOF OF ADDRESS
BRING ONE OF THE FOLLOWING:
Recent utility bill with name on it or mail with current postal date and name. If living in a shelter or treatment facility, provide a letter from them stating your stay at the facility
HEALTH HISTORY
List of names and contact numbers of physicians, clinics, and hospitals that have treated you in the past 2 years including previous hospitalizations and surgeries (with dates). List of current medications (dose and frequency) including medications you are allergic to and the reaction you experience, as well as over-the-counter or herbal medications you take on a regular basis.
MONTHLY INCOME ESTIMATE
Monthly income statement – this information will be used to determine if you qualify for other services and will not affect your eligibility to receive health services from Ruby’s Well Care.
How to Use These Well Care Services
These services were specifically designed for Polk or Burnett County residents that fall within our income criteria. Please follow these simple steps to take advantage of these free services:
- Fill out the Ruby’s Well Care application. See information above for proof of identity and address.
- Submit application and await approval (takes 4-6 days).
- Upon approval, schedule your appointment by calling 715-472-7770.