Become a Patient
Since 1984, DAP has offered accessible, comprehensive healthcare to residents of the Coachella Valley. Our dedicated medical staff provides onsite services from wellness checks to managing long term conditions.
Contact an Enrollment Specialist
Complete the form below, or if you prefer to speak with an enrollment specialist, call
(760) 323-2118 ext. 762
Thank you for contacting us. An enrollment specialist will be in touch soon.
Please download and fill in the following forms which you will need to submit to D.A.P. upon your next visit. If you are unable to download, print and complete the forms below, please visit us and speak with an enrollment specialist to complete the necessary applications on site.
Identification will be required when submitting your enrollment forms above. See Insurance and Payments for more information on our low-cost payments and sliding fee scale. No one will be turned away due to an inability to pay.
HIV Positive Patients:
In addition to the above enrollment form, please download and print the HIV Health History Form below.
In addition to the above enrollment form, please download and print the HIV Health History Form below. The following additional documentation might be necessary to determine eligibility for additional services for those living with HIV.
• Proof of Insurance: See Insurance and Payments for more information.
• Proof of Riverside/San Bernardino County Residency
• Proof of HIV Diagnosis
• Proof of Total Monthly Income
We use a sliding scale to determine financial assistance based on income and family size per the Federal Poverty Guidelines.
Ryan White Eligibility
The Ryan White HIV/AIDS Program grant ensures healthcare and living needs are met. 50% of our AIDS patients receive funding.
The uninsured will not be turned away. We'll help you determine your eligibility for various aide options and process claims.