2026-02-25T09:49:06-06:00 2025-06-30 540618213 HANTZMON WIEBEL LLP PO BOX 1408 CHARLOTTESVILLE VA 22902 990 2024-07-01 541610405 CHARLOTTESVILLE FREE CLINIC CHAR 4342965525 901 PRESTON AVE 301 CHARLOTTESVILLE VA 22903 WILLA BARNHARDT EXECUTIVE DIRECTOR 4342958967 2026-02-24 1 0 CLARISSA B HOFFMAN P01390684 4342962156 2024 2025-03-06 01:10:19Z WILLA BARNHARDT 901 PRESTON AVE 301 CHARLOTTESVILLE VA 22903 4421200 0 X WWW.CVILLEFREECLINIC.ORG X 1991 VA THE CHARLOTTESVILLE FREE CLINIC'S MISSION IS TO:1. PROVIDE A COMMUNITY HEALTH SUPPORT SYSTEM THAT PROVIDES HIGH-QUALITY MEDICAL, MENTAL HEALTH, VISION, AND DENTAL SERVICES TO LOW-INCOME, UNINSURED, AND UNDERINSURED INDIVIDUALS WHO HAVE NO OTHER OPTION FOR CARE, AT NO COST TO PATIENTS.2. PROVIDE PRACTICAL EXPERIENCE FOR CURRENT AND FUTURE HEALTH CARE PROFESSIONALS.3. HASTEN, THROUGH EDUCATION AND ADVOCACY, THE CREATION OF A COMPREHENSIVE POLICY FOR ACCESS TO HEALTH CARE. 16 16 32 648 0 0 4044601 4101460 0 0 177610 169539 -55879 8670 4166332 4279669 0 0 0 0 1677420 1776676 0 0 160440 2205348 2143845 3882768 3920521 283564 359148 5191161 5578717 8464 10070 5182697 5568647 X THE CHARLOTTESVILLE FREE CLINIC'S MISSION IS TO PROVIDE A VOLUNTEER-DRIVEN, COMMUNITY HEALTH SUPPORT SYSTEM THAT PROVIDES HIGH-QUALITY MEDICAL, MENTAL HEALTH, VISION, AND DENTAL SERVICES TO LOW-INCOME, UNINSURED AND UNDERINSURED INDIVIDUALS WHO HAVE NO OTHER OPTIONS FOR CARE, AT NO COST TO PATIENTS. 0 0 3556904 THE CHARLOTTESVILLE FREE CLINIC (CLINIC) PROVIDES MEDICAL CARE, DENTAL CARE AND PHARMACEUTICALS TO QUALIFYING INDIVIDUALS WHO DO NOT QUALIFY FOR MEDICARE AND/OR MEDICAID, AND ARE UNINSURED OR UNDERINSURED. THE CLINIC ENCOURAGES PATIENTS TO SEEK TREATMENT EARLY BEFORE SMALL PROBLEMS BECOME LARGE PROBLEMS.THE CLINIC RECEIVED SUPPORT IN THE FORM OF DONATED SERVICES, FACILITIES, AND PHARMACEUTICALS. - THE DONATED SERVICES, VALUED AT $452,694, WERE PROVIDED BY HEALTH CARE PROFESSIONALS, PHARMACISTS, LAB TECHNICIANS AND OTHER PROFESSIONALS. - THE DONATED FACILITY WAS VALUED AT $40,000. - THE DONATED PHARMACEUTICALS WERE VALUED AT $1,318,568. THE SERVICES ARE PROVIDED BY APPROXIMATELY 648 VOLUNTEERS FROM THROUGHOUT THE COMMUNITY, INCLUDING MEDICAL STAFF AND OTHER HEALTH PROFESSIONALS FROM LOCAL HOSPITALS AND OTHER COMMUNITY HEALTH FACILITIES. ON-SITE SERVICES INCLUDE MEDICAL AND NURSING ASSISTANCE FOR PRIMARY CARE, MENTAL HEALTH ISSUES, BASIC LAB TESTING, INDIVIDUAL AND GROUP HEALTH EDUCATION PROGRAMS, DENTAL SERVICES, AND A FULLY LICENSED PHARMACY. REFERRAL SERVICES INCLUDE COMPREHENSIVE LAB TESTING, RADIOLOGY SERVICES AND OTHER MEDICAL SPECIALTY SERVICES. ALL SERVICES, SUPPLIES AND MEDICATION ARE PROVIDED FREE OF CHARGE. 3556904 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 8 0 1 32 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VA X WILLA BARNHARDT 4342965525 901 PRESTON AVE 301 CHARLOTTESVILLE VA 22903 WILL KNIGHT CHAIR 2.00 X X 0 0 0 JACK KAYTON VICE CHAIR 1.00 X X 0 0 0 MICHAEL BROOKS TREASURER 1.00 X X 0 0 0 SANDHYA CHHABRA SECRETARY 1.00 X X 0 0 0 JULIANA BUENO DIRECTOR 1.00 X 0 0 0 KARA COMER DIRECTOR 1.00 X 0 0 0 TRACY DOWNS DIRECTOR 1.00 X 0 0 0 TED HORN DIRECTOR 1.00 X 0 0 0 JIMMY LEE DIRECTOR 1.00 X 0 0 0 MAX LUNA DIRECTOR 1.00 X 0 0 0 MARY MCKENZIE DIRECTOR 1.00 X 0 0 0 PORTER NOLAN DIRECTOR 1.00 X 0 0 0 AMIT SHAHANE DIRECTOR 1.00 X 0 0 0 KIMBERLY SKELLY DIRECTOR 1.00 X 0 0 0 NATE TRICKER DIRECTOR 1.00 X 0 0 0 GREG WINSTON DIRECTOR 1.00 X 0 0 0 WILLA BARNHARDT EXECUTIVE DIRECTOR 1.00 X 129550 0 8974 JONATHAN LEIST DENTIST 1.00 X 194353 0 10948 MEGHAN HINGER CEO OF CLINICAL OPERATIONS 1.00 X 138250 0 10863 PATRICIA POLGAR-BAILEY FAMILY NURSE PRACTITIONER 1.00 X 135973 0 36368 CHRISTINE LANE DENTAL HYGIENIST 1.00 X 100977 0 15346 699103 0 82499 5 0 1 0 0 256872 278699 3565889 1414158 4101460 170239 170239 94890 95590 -700 -700 -700 39546 256872 45941 -6395 -6395 CONTRACT SERVICES & RE 621400 15065 15065 15065 4279669 15065 0 163144 154594 77297 77297 1327414 1273291 23152 30971 28430 27725 272 433 155295 136348 9079 9868 110943 95744 7322 7877 44600 5520 39080 129057 120738 5550 2769 1518 1366 76 76 24410 699 5084 18627 17466 10036 7430 205522 203318 1102 1102 15558 14555 1003 146333 124383 20487 1463 11901 9521 1190 1190 SUPPLIES 1458749 1458142 0 607 MEMBERSHIP 32792 32792 0 0 VOLUNTEER PROGRAM 21014 21014 0 0 REPAIRS & MAINTENANCE 19136 6313 12483 340 15789 15399 390 3920521 3556904 203177 160440 2355647 616123 686750 1139812 703458 560803 436354 490342 2112565 3224282 162146 124866 5191161 5578717 8464 10070 8464 10070 X 5040501 5458787 142196 109860 5182697 5568647 5191161 5578717 359148 26802 0 X X 0 1 X 1 0 X 3331397 3490853 4111995 4044601 4101460 19080306 3331397 3490853 4111995 4044601 4101460 19080306 659314 18420992 12193 3851 67755 177101 170329 431229 393400 41989 198419 74423 54611 762842 20274377 26790 0.90860 0.91270 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SPECIAL EVENT PROCEEDS - 2021 AMOUNT: $ 21,200. 2022 AMOUNT: $ 112,639. 2023 AMOUNT: $ 60,101. 2024 AMOUNT: $ 39,546. PPP LOAN INCOME - 2020 AMOUNT: $ 393,400. SERVICE CONTRACT REIMBURSEMENTS - 2021 AMOUNT: $ 20,789. 2022 AMOUNT: $ 85,780. 2023 AMOUNT: $ 14,322. 2024 AMOUNT: $ 15,065. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 568729 269559 299170 551083 413899 137184 20000 20000 0 436354 CERTIFICATES OF DEPOSIT (CD) 3224282 F 3224282 X 4799165 26802 492694 519496 4279669 0 4279669 4413215 492694 492694 3920521 0 3920521 PART X, LINE 2: THE CLINIC HAS REVIEWED AND EVALUATED THE RELEVANT TECHNICAL MERITS OF EACH OF ITS TAX POSITIONS IN ACCORDANCE WITH GUIDANCE ESTABLISHED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT WOULD HAVE A MATERIAL IMPACT ON THE FINANCIAL STATEMENTS OF THE CLINIC. CONCERTS 257854 221508 36346 28553 4191 OTHER 38564 35364 3200 4574 7834 789 296418 256872 39546 4574 36387 4980 45941 -6395 SCHEDULE G PART II: FUNDRAISING EVENTS SPECIAL EVENTS ARE REPORTED AS REVENUE IN THE YEAR CASH IS RECEIVED. THE RELATED EXPENSES ARE RECOGNIZED WHEN CASH IS PAID. X X X 0 0 0 0 0 0 0 0 0 JONATHAN LEIST DENTIST 186103 0 8000 0 250 0 5760 0 5188 0 205301 0 0 0 PATRICIA POLGAR-BAILEY FAMILY NURSE PRACTITIONER 128223 0 7500 0 250 0 3847 0 32521 0 172341 0 0 0 X 10 95590 FMV DATE OF TRANSFER X 1 1318568 RETAIL VALUE 0 0 1 PART I, COLUMN (B): THE CLINIC IS REPORTING THE TOTAL NUMBER OF CONTRIBUTIONS, WITH EACH CONTRIBUTION POTENTIALLY COMPRISING MULTIPLE ITEMS. PART I, LINE 32B: STOCK CONTRIBUTIONS ARE PROCESSED BY WELLS FARGO ADVISORS. THE BROKER CONFIRMS WITH THE EXECUTIVE DIRECTOR THE GIFT, NUMBER OF SHARES, AND DONOR NAME, AND OBTAINS APPROVAL TO SELL SHARES. FUNDS ARE TRANSFERRED TO THE BANK ACCOUNT AND FOLLOWS STANDARD GIFT PROCESSING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND TREASURER AND IS DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER IS MADE AWARE OF, AND SIGNS, THE WRITTEN CONFLICT OF INTEREST POLICY. POTENTIAL CONFLICTS OF INTERESTS ARE REQUIRED TO BE DISCLOSED AT THE EARLIEST PRACTICAL TIME. NO BOARD MEMBER SHALL VOTE ON ANY MATTER IN WHICH SUCH BOARD MEMBER HAS A CONFLICT OF INTEREST. ANY BOARD MEMBER, WHO IS UNCERTAIN WHETHER A CONFLICT OF INTERESTS EXISTS, MAY REQUEST THE BOARD TO MAKE A DETERMINATION REGARDING THE EXISTENCE OF A CONFLICT OF INTEREST, AND THE BOARD SHALL RESOLVE THE QUESTION BY A MAJORITY VOTE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REFERENCES SALARY SURVEYS PUBLISHED BY THE VIRGINIA ASSOCIATION OF FREE CLINICS AND CHARLOTTESVILLE'S CENTER FOR NONPROFIT EXCELLENCE IN DETERMINING SALARIES OF ALL STAFF, INCLUDING THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 18 COPIES OF THE 990 ARE KEPT IN THE EXECUTIVE DIRECTOR'S OFFICE AND AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, RELATED POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE, UPON REQUEST, AT THE ORGANIZATION'S OFFICE. FORM 990, PART XII, QUESTION 2C - OVERSIGHT PROCESS THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.