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What’s required?

  • Proof of Identity

    Any type of identification with your picture and name: such as a driver’s license, state issued ID, school ID or work ID. Documents such a birth certificates, school documents and immigration application are needed to establish dependent qualification. Dependents age 21 and younger qualify as part of a household.

  • Proof of Address

    Examples include utility bill (cable bill, cell phone bill, etc.), copy of lease agreement, voter registration card, automobile insurance documents or any piece of postmarked mail you have received recently.

  • Proof of Income

    Recent proof (dated within the last 45 days) of all household income including earned and unearned income. This would also include income for your spouse and any minor children for the past 30 days.

Providing Proof of Income

  • What is earned income?

    Earned income is paid through employment. Most earned income will be countable by pay stubs provided through your employer. Cash or self-employment income can also be counted by completing the forms.

  • What is unearned income?

    Unearned income is provided through financial support (usually a family member or friend), legal judgements (like child support), retirement, investments, social security, disability payments, etc. Supporters can complete the form.

Sliding Fee Discount Program Email

  • Do you need to submit an electronic copy of a document or send written message regarding the Sliding Fee Discount Program? Please email us at



To ensure the Family Care Center provides the greatest discount to each patient, Sliding Fee Discount Program applications are completed in person with an eligibility specialist. Call us today! 713-743-9682

Find Us


UH Health Family Care Center
University of Houston Campus
Health 2 Building, Suite 1001E
4349 Martin Luther King Boulevard, Houston TX, 77204


Business hours: M-F 8 a.m. - 5 p.m.
Phone: 713-743-9682
Fax: 713-743-1049