Patient Information

Patient Eligibility

  1. 18 years to 65th birthday
  2. A resident of Horry County
  3. 200% or below Federal Poverty Guidelines
  4. No access to medical insurance, Medicaid or Medicare

Application Process

Applications to become a patient at Friendship Medical Clinic may be mailed, e-mailed or downloaded from this website. Applications may also be picked up in person at 1396 HWY 544 Conway, SC (Monday – Thursday 830am- 4pm)

Patient Application Form

Download Here

PLEASE READ INSTRUCTIONS CAREFULLY WHEN COMPLETING THE APPLICATION

Documents Required for Application

  1. Photo ID (South Carolina driver’s license or South Carolina photo ID)
  2. Verification of Income:

    • Tax return for the previous tax year
    • Last two pay stubs may be used if no tax returns are available.

Please call the clinic Patient line 843-347-7178 Monday-Thursday 9 a.m. - 1 p.m. with any questions regarding the application or application process. We want to help you receive medical care and medications.

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Patient Information

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