LETTER OF SUPPORT - Lloyd F Moss Free Clinic - lloydfmossfreeclinic 2026

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The document is a Letter of Support from the Lloyd F. Moss Free Clinic, intended for a patient, outlining the services provided by a supporter. It includes sections for the supporter to indicate their relationship to the patient, confirm residency, and specify types of support such as food, housing, financial assistance, and transportation.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the date at the top of the form. Ensure you format it correctly as MM/DD/YYYY.
In the section for Patient’s SSN, input the patient’s Social Security Number in the designated format.
Next, fill in your name as the supporter in the provided space. This identifies you as the individual providing support.
Enter the patient's name in the corresponding field to specify who you are supporting.
Check all applicable services you provide, such as food, housing/rent, financial support, or transportation. If 'Other' is selected, specify what additional support you offer.
Complete your personal information below: print your name, address, phone number, and relationship to the patient.
Finally, sign the document to validate your support and ensure that current identification is attached for verification purposes.

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What is considered a free-standing clinic?

Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times.

What are the positives of free healthcare?

Freestanding (or stand-alone) facilities provide medical services under the direction of a physician, but theyre not part of a hospital.

How are free clinics funded?

The Free Clinics has a diversified funding base that includes donations, special events, state and local government support, foundation and corporate grants, United Way funding, service and/or rental contracts, limited fee-for-service, and interest income.

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Is Moss Free Clinic closed?

Moss Free Clinic has closed its doors due to insufficient funding. We are heartbroken by this difficult reality, but incredibly proud of the care our dedicated staff and volunteers have provided over the decades.

What are the benefits of free clinics?

Today, most uninsured patients report that they would either not seek medical care or would use the emergency department if free clinics were not available [4]. Free clinics lessen the burden placed on emergency departments while providing care that is comparable to the national standard of care [13-14].

LETTER OF SUPPORT - Lloyd F Moss Free Clinic - lloydfmossfreeclinic 2026

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