Current Patient Resources
If you are a current patient on Project Access and you need to re-enroll please use the following forms below. You must provide current proof of address and income with your re-enrollment form. (See acceptable sources of proof document below)
PLEASE NOTE: If your enrollment expired more than 30 days ago, you will be required to complete a NEW application. Please visit the "new patients resources" page to complete the correct application.
RE-ENROLLMENT FORMS
Re-enrollment Application (PDF)
Re-enrollment Application (Fillable PDF)
Acceptable Sources Of Proofs (PDF)
Patient Responsibility Form (PDF)
No Income - Transient Form (PDF)
Once you have completed the re-enrollment application you may email it along with your acceptable proof documents to projectaccess@medicalbureau.net, submit it by mail to Project Access - 2612 Commons Boulevard - Augusta, GA 30909 or via fax to (706) 736-8055. If you have questions concerning your re-enrollment please call (706) 733-5177.
