Before You Start

Be sure you have the following documents ready before you start this application:

• Articles of Incorporation
• Federal Tax Exemption as 501(c)3
• Copy of Bylaws
• Written policy of non-discrimination on ability to pay/sliding fee scale
• Copy of current state licenses for each clinical site
• Copy of most recent financial audit
• Copies of two (2) most recent HCAI Reports
• Copy of most recent IRS form 990
• Two (2) letters of recommendation from current CCALAC members in good standing in the same Service Planning Area (SPA)
• Electronic Logo

Please complete the application and attach all required documents.

Membership Dues

Annual Dues as Percentage of Clinic Budget
0.18 % 

Annual Dues Cap
$40,000

If you have any questions, please contact Nina Vaccaro, Chief Operating Officer.