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Registration and Eligibility

Florida Department of Health in Hardee County

To decrease the time spent in the registration process, we have made it possible to complete your registration information prior to your appointment.

Print, fill out the form below, and bring it with you.

Client Registration Form-English (PDF 664 kb - opens in new window)

Client Registration Form-Spanish (PDF 682 kb - opens in new window)

Be sure to bring the following with you:

  • Driver's License or Valid Identification (ID)
  • Proof of Income* (Last 4 paycheck stubs)
  • Proof of Insurance (If applicable)
  • Completed Registration Form

*Required for some programs

Sliding fee scales produced by the Florida Department of Health help to make services more affordable for clients. Financially eligible clients are not required to pay full charges to receive most Florida Department of Health services, including communicable disease and integrated family health services.  All clients, regardless of poverty level, are required to pay the full cost for other Florida Department of Health services, such as vital statistics services and international immunizations. Fee schedule is available upon request.