Clinical Services



Three Rivers Health offers immunization services for children, preteen/teens, and adults at each county health department. Please call for an appointment and bring current immunization records, insurance cards, and proof of income to your appointment. Costs vary by vaccine depending upon any insurance coverage and income level. Providing proof of income level may reduce or eliminate your need to pay. (Proof of income = three months of pay stubs, a letter from employer stating salary, tax return from previous year.)


Certain vaccines are required by the Code of Virginia for day care and school entry. These vaccines are provided by the health department without charge regardless of insurance status.

School and Day Care Immunization Requirements in Virginia

Other vaccines are recommended, but not required, by the Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP).

Recommended vaccines for children birth to 6 years

Children who are eligible for the Vaccines for Children Federal Program can receive these vaccines free however there is an administration fee. The administration fee may be decreased based on income.


Even though they’re almost grown up, pre-teens and adolescents need vaccines. Tdap (pertussis or whooping cough) boosters are required for rising 6th grade students. Meningitis vaccine, and  HPV (human papilloma virus) vaccine are recommended. There is an administration fee for recommended vaccines. The administration fee may be decreased based on income.

Recommended vaccines for preteens and teens


Adults need vaccines too.  Recommended adult immunizations are offered for tetanus, diphtheria and pertussis (whooping cough), hepatitis B, pneumococcal pneumonia, meningococcal meningitis, measles, mumps, rubella, varicella and zoster (shingles). Charges may apply for the cost of the vaccine and administration fees based on insurance status and income.  Adults without insurance or whose health insurance does not cover vaccines may receive vaccines recommended by the Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP) at no charge; however, there will be an administration fee based on income.


Influenza immunizations are provided to children six months through 18 years who are VFC eligible Vaccines for Children Federal Program and adults who do not have health insurance or their health insurance does not cover vaccines.  There is an administration fee. The administration fee may be decreased based on income.


Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats, and foxes.

The rabies virus infects the central nervous system, ultimately causing disease in the brain and death; therefore, any exposures should be evaluated promptly.


Rabies pre-exposure vaccinations are recommended for certain people according to their risk of exposure which is often related to their job or hobbies. The series consists of three shots given in the arm. Contact your physician or local Health Department if you are interested in obtaining pre-exposure vaccine. The Health Department charges a fee for this service. Call for current prices.

Rabies - CDC

Rabies Prevention - Environmental Health


If you think you may have been exposed to rabies through a bite or scratch of an infected animal, consult your physician or the local health department as soon as possible. If it is determined that rabies post-exposure treatment is necessary, your doctor or the local Emergency Department will administer Human Rabies Immune Globulin at the site of the bite or exposure (not administered at the Health Department) and the first of four doses of Rabies Vaccine will be administered in your arm. You may also need a tetanus shot. You will then need to make arrangements for your next three shots. These shots are spaced out over the next two weeks.

If you do not have insurance you can receive the remaining three doses of Rabies Vaccine at the Health Department. You will need to call for an appointment.  The fee will be based on your income.

If you have previously received post-exposure vaccinations or received pre-exposure vaccinations and have another exposure, only two doses of vaccine (one on the day of exposure and another 3 days later) are needed. Human rabies immune globulin is not required. Your doctor or local health department will be able to guide you through the process.

When should I seek medical attention?

What is the treatment if I’ve been exposed to a rabid animal?

Family Planning

Three Rivers' nursing team provides education and counseling about reproductive health including clinical assessment and birth control services to male and female clients using a client-centered approach. Services are available for insured and uninsured
patients on sliding scale income basis. Preexposure Prophylaxis services are offered to those clients at high risk for HIV.  To access family planning services, please contact your local health department.

School Entrance Examinations

The health department performs school entrance physical examinations for medically indigent children without charge. These examinations are done by appointment only.

Enrollment in Virginia Public Schools and guidelines for school physicals

Commonwealth of Virginia School Health Form

Long Term Care Screenings

Nursing Home and Community Based Care Pre-Admission Screening is a Virginia Medical Assistance funded program (Medicaid). It is a program designed to provide services in the home and/or community for adults and children who would otherwise require nursing facility placement. If you or someone in your family needs nursing facility care or personal care in the home and cannot afford the cost, you may be eligible to have this service covered by Medicaid. For financial eligibility contact your local social services (DSS) for an application or apply for Medicaid online.

Adult Screenings

Inquiries and requests for adult screenings should be directed to the Department of Social Services (DSS) in your county. A DSS intake worker will collect information concerning the request. A nurse from the local Health Department and an adult service worker from the local DSS office will then schedule a visit with the patient at their home to determine if they meet Medicaid’s nursing facility criteria then this information is given to the local Health Department director. A decision is made as to whether or not nursing facility placement or personal care services in the home is the appropriate level of care to meet the patient’s needs. The preadmission screening process may also be completed by a hospital screening committee if the person is in an acute care hospital at the time the placement is needed.

Screenings for Children

Effective June 1, 2016, inquiries and requests for children’s screenings should be directed to the Health Department. A Public Health Nurse will collect information and schedule a visit with the patient at their home. Medicaid assessment will be completed to determine the level of care the patient needs. If the level of care the patient needs meets Medicaid’s nursing facility criteria then this information is given to the local Health Department director. A decision is made as to whether or not nursing facility placement or personal care services in the home is the appropriate level of care to meet the patient’s needs.

Tuberculosis (TB)

Tuberculosis (TB) is an infectious disease caused by germs that are spread from person to person through the air. TB usually affects the lungs; but it can also affect other parts of the body, such as the brain, the kidneys, or the spine.

If you have symptoms that could be TB or have been in close contact with someone who has active TB disease, you should call your healthcare provider or your local health department.

In addition to screening and testing individuals who may have been exposed to TB, the local health departments also investigate reports of suspected or verified TB cases within their jurisdiction. We provide case management services involving the patient, family, the managing physician, and the state TB Control and Prevention Program to ensure timely and appropriate treatment of TB disease in order to protect our communities.

HIV Prevention, Care and Support Services

Supported by CDC HIV Prevention and Ryan White HIV/AIDS Program Funds


Three Rivers Health partners with Eastern Virginia Medical School to provide medical care at the Gloucester health department. For eligibility information or an enrollment packet.

Contact Gloucester Health Department
PO Box 663
Gloucester, VA 23061


Three Rivers Health offers qualifying HIV+ individuals a variety of supportive services and resources to keep people living with HIV healthy and engaged in treatment. Services include:

  • Case Management
  • Transportation
  • Dental Care
  • Mental Health Care
  • Substance Abuse Services
  • Nutrition Services
  • Insurance enrollment/ navigation/ education
  • Co-payment Assistance
  • Assistance with accessing HIV medication


Three Rivers Health provides written or web based information, one on one counseling, or group education for anyone interested in learning about HIV, how to reduce their risk of acquiring the virus, or how the virus affects the body. We also offer PrEP (pre-exposure prophylaxis) the daily medication that can prevent you from getting HIV if you are at risk. Three Rivers offers HIV testing in select locations with quick linkage into medical care if test is positive. We are also committed to engaging HIV+ individuals who have fallen out of care back into receiving services. For more information on testing or services call the Gloucester Health Department at 804-693-2445 or to schedule an appointment for PrEP call your local health department.

HIV Prevention


Healthline 1-800-822-7422


The goal of Early Intervention Services (EIS) is to locate individuals who have the HIV virus, but are unaware they do. By offering free testing at community events, county health departments, and
professional trainings, the Three Rivers Health District aims to link individuals who are HIV positive with the proper treatment, services, and support they need to live a long and happy life. The earlier an individual with the HIV virus is treated, the greater their health outcome. EIS also offers counseling and information to the community on sexually transmitted infections.