Please mail the application and proof of income* to this address:
Maria Shamblin
CCHS Patient Assistance Coordinator
Clendenin Health Center
107 Koontz Ave, Suite 200
Clendenin, WV 25054
*Acceptable proof of income includes: wage statement, social security check or benefit letter, SNAP Benefit letter, alimony check, child support check, food stamp voucher, Unemployment Weekly Benefit Letter, financial assistance from family member or friend, retirement benefit statements or other income documents you may have.