to become a patient, please:

Complete a new patient application. You can download one by clicking the appropriate application button below.

Only completed applications with copies of the required documents will be processed. 

In addition to a completed patient application, the following documents are also required: 

  • Copy of Social Security Card (if available) for each applicant

  • Copy of picture identification for each applicant

  • To be screened for eligibility for the Sliding Fee Discount applicants must also provide family size and proof of earned income through one of the following document(s):

    • Current Federal income tax return

    • Social Security or disability letter (must be a letter from Social Security Administration)

    • 30 days paystubs (most recent)

    • Unemployment Benefits (must be a letter from Unemployment department)

    • Letter from a shelter on organizational letterhead where applicant resides

    • Letter from employer on company letterhead documenting the hours worked and rate of pay or signed and notarized GSCC Employer Declaration Notice

    • Department of Human Services Child Support Statement or proof of alimony

    • Self-declaration on GSCC Self-Declaration Form is allowed for homeless individuals/families

ALL paperwork must be completed prior to being seen at the clinic.


Patients must provide family size and proof of income that verifies income levels are at or below 200% of the Federal Poverty Level.

Click here to view the Sliding Fee Discount Schedule (SFDS)


English Applications and Forms:

Patient Handbook:

Good Shepherd community clinic, Inc.

Twenty 12th Avenue NW
Ardmore, Oklahoma 73401

Medical Appointments: 580.223.3411

Dental Appointments: 580.223.2006

Pharmacy: 580.826.3575

Clinic Hours:

Monday 9a to 6p

Tuesday 9a to 6p

Wednesday 9a to 6p

Thursday 9a to 6p

Friday 8a to 12p (Walk-In Urgent Care Only)