The PATH Clinic in Birmingham, Alabama, is a free clinic for uninsured patients with uncontrolled diabetes. In its first 22 months, more than 25% of patients were lost to follow-up. This report shares reasons for patients becoming lost to follow-up. Investigators used patient records for quantitative analyses and phone interviews for qualitative analysis. Sociodemographic factors were not associated with patients’ likelihood of becoming lost to follow-up. Qualitative results show that these patients had uncertainty regarding appointment dates, complicated life circumstances, and transportation barriers. Results indicate that social interventions may improve patient compliance and retention and should be tested.