Who can apply

Only Powhatan County residents are accepted

Children 18 years old and under, Adults 60 years old and over, and those on Social Security or Veterans Administration disability. Proof of receiving disability is required. No exceptions

We use 250% Federal Poverty Income Guidelines. These are based on the Federal Poverty Guidelines as provided by the Federal Office of management and Budget. 

How to apply

What to bring or send

• Proof of residency (current light bill with applicant’s name and address or other official proof)

• Proof of income for all household members (recent pay stub, social services letter, copy of child support award).                        If self-employed we will need latest 1040 tax return.

• Proof of disability (letter showing disability payments)

• Proof of custody (court order or custody papers)

Failure to send all required information could cause a delay in processing your application.

Those that would rather mail an application can pick one up at:

Free Clinic of Powhatan or Powhatan Public Library or print one from here.

2025 app word

 

 

2025 app PDF

 

Only Powhatan County residents are accepted

Applications will be taken starting October 2026

 

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