Using the Hannibal Free Clinic is easy. First, see below if you are eligible to receive services. Secondly, fill out a patient application form. Click here to download the form and see below for how to apply.

Finally, after the patient application form has been submitted and your are eligible for services, the Hannibal Free Clinic will call to set up your first appointment. If you have any questions, please feel free to call us at 573-248-8307.

Am I Eligible For Services?

Pre-scheduled basic healthcare is provided by the Hannibal Free Clinic to those who:
Have no health insurance and have incomes lower than 150% of poverty.

Patients limited to counties – Lewis, Marion, Monroe, Pike, Ralls, Shelby

Current 2016 Federal Poverty guidelines @ 150%

Persons in household:                        Income:
1                                                                       $17,820
2                                                                      $24,030
3                                                                      $30,240
4                                                                      $36,450
5                                                                      $42,660
6                                                                      $48,870
7                                                                      $55,095

8                                                                      $61,335

Each additional family member           $  6,240

In order for you to receive services from the Hannibal Free Clinic, you must first be determined eligible for services. THIS IS NOT A WALK-IN CLINIC. Volunteer Doctors and Nurses are only available by scheduled appointments.

An eligibility form (which must be completed prior to scheduling an appointment) is included on the website. If you need assistance in completing this form, please contact the clinic. We have volunteers who can assist you.

The basic information we need to determine whether you are eligible includes:

  • A copy of your last year’s 1040 can also be used to verify your income. Having a copy of your recent 1040 is frequently necessary if the clinic volunteers are helping you obtain medications from pharmaceutical company patient assistance programs.
  • List of names and addresses of all healthcare providers that you have seen. A release of information is included on the second page of the application.  You will not be able to be scheduled for an appointment until your medical records have been obtained.
  • List of your current medications or bring the bottles.

Persons meeting eligibility criteria will be scheduled with an appointment as soon as one is available.  Please remember that the Hannibal Free Clinic is a VOLUNTEER clinic with limited resources.  We are not a State or Federal Agency.  All of our support comes from our COMMUNITY.  If you are scheduled at the clinic, we will do all that we can to assist you with your healthcare concerns, but please be patient with the time it may take to serve you.

If you are unsure whether you are eligible to receive services please feel free to contact us via phone (573) 248-8307 or click here to e-mail us. If you believe you are eligible, please complete the form in the next section “how do I apply” so that a representative of the free clinic can review your application and consider your eligibility.

How to Apply

To become eligible for services, please complete the following form:
Patient Application Form

Once completed, you may mail it to:

Hannibal Free Clinic
160 Progress Road
Hannibal, MO 63401

Click here to send application by email.

Or fax it to 573-248- 8350
Attention: Clinical Coordinator.

Or hand-deliver it to the Hannibal Free Clinic.
Attention: Clinical Coordinator.

We will review your application and contact you regarding your eligibility to be cared for at the Hannibal Free Clinic. Please be sure to complete your application completely and attach supporting income verification.  Applications cannot be considered without this information.  Failure to provide all requested information will slow the application process and delay your appointment.  Follow-up appointments will be made at time of service or if you have a change in condition and need to see the physician prior to your next appointment you can call the clinic and speak with the nurse.


Services are available only by appointment for eligible patients. They include:

  1. Basic healthcare services
  2. Assistance with medications
  3. Support for accessing other healthcare services
  4. Basic Dental Services

Our services are available to those with stable chronic conditions who are not covered by any form of insurance and have an income below 150% of poverty. Patients will be screened for eligibility prior to being served in the free clinic. If a potential patient is not eligible to receive free services at the clinic due to either the nature of the health condition or the financial situation, every effort will be made to refer the patient to a more appropriate resource. Patients will be invited to make a donation to the clinic but will not be charged for their services.

Healthcare services in the clinic are provided by volunteer physicians and nurse practitioners. Routine lab and radiology services are provided by charitable contributions from the hospital, radiologists, pathologists and local physician clinics.

The Hannibal Free Clinic is partnering with Hannibal-LaGrange College and other schools of nursing to become a clinical practice site for nursing students. Medication assistance is provided through donations from pharmaceutical programs, samples donated by local physicians and pharmacies, and federal and state programs for which eligibility is verified.