New Patient Information

YOUR GUIDE

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BECOMING A PATIENT

FastTrack | Priority ZIP Codes 30318 and 30314

  • We are always accepting prenatal and pediatric patients. Please call 404-523-6571 for more information.
  • Can register at any time by calling: 678-515-0258 or Email: FastTrack@goodsamatlanta.org
  • Requires proof of income, address, ID, and insurance card (if applicable). You must have these documents to be seen.

Non-FastTrack | Outside of priority ZIP Codes.

  • Phone line lottery - first come first serve and occurs on a monthly basis. Please call 678-515-0241 to hear when our next registration date is.
  • When phone registration is open please leave your first and last name, county of residence and all phones numbers where you can be reached. Only one attempt will be made to reach new patients. If the message box is full, please try calling back on the first day of the next month. The phone line is ONLY open as capacity permits.
  • Proof of income and insurance card (if applicable). A NO SHOW will require call again.
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DOCUMENTS TO BRING

We are not a free clinic. For patients without insurance, services are offered on a sliding fee scale. Patients are eligible to receive care determined by income and household size, based on 200% and below Federal Poverty Guidelines. Students and residents of rehabilitation centers, shelters, or transitional housing are eligible to become a patient. We accept Medicaid, Medicare, and select insurance for primary care only.  

  • Proof of Identification (Drivers Licenses, ID Card, Passport)
  • Proof of Income (W2 Statement, Last Three Paycheck stubs, unemployment letter from Department of Labor, Notarized Letter from Employer or current Tax Return)*Proof of income MUST be updated every year. All proof of income expires May 31st*
  • Patients residing in a shelter or rehabilitation center must provide a letter confirming their residency and employment status to receive free service.
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OUR FEES EXPLAINED

Good Sam believes in making high-quality dental and medical care available for every family regardless of their financial situation. We expect our patients to pay according to their ability.

Dental
All dental fees vary based on procedures. We do not accept insurance for dental procedures.

Counseling
Individual and family counseling is offered at an affordable price.  Please call 404-523-6571 for more information.

Medical
All medical fees vary based on income. A medical office visit can range between $40-120 per visit as determined by Federal Poverty Guidelines for FASTTRACK patients (ZIP codes of 30318/30314) and $60-140 for patients outside the priority ZIP codes of 30318/30314.

PLEASE NOTE: Immunization Records, Medical Records, Referral Vouchers and other administrative services are a separate cost.

Patients with income 200% and above the federal poverty level are responsible for the full cost of services.

Household Size 100% 138% 150% 200%
1 $11,770 $16,242 $17,655 $23,540
2 $15,930 $21,983 $23,895 $31,860
3 $20,090 $27,724 $30,135 $40,180
4 $24,250 $33,465 $36,375 $48,500
5 $28,410 $39,205 $42,615 $56,820
6 $32,570 $44,946 $48,855 $65,140
7 $36,730 $50,687 $55,095 $73,460
8 $40,890 $56,428 $61,335 $81,780