Patient Resources

In order to better serve you and speed up the process during your visit, please feel free to print and complete any of the following forms applicable to your visit. Arriving with all necessary paperwork may allow our staff to process your paperwork quicker during check-in while shortening your overall wait time. Although this can shorten your overall wait time, please note that this does not guarantee that you will be seen immediately upon check-in. 

For patients that don’t have insurance, this practice serves all patients regardless of ability to pay. Discounts for essential primary care, dental and mental health services are offered depending on family size and income— based on a Sliding Fee Discount Program. The Sliding Fee form can be found below. Please fill out the form and bring it with you on your upcoming appointment.

If you have questions about any of our forms, please Contact a member of our staff for more information.

As a reminder, please remember to bring your insurance card (if applicable) and photo ID when you visit our office.


Helpful Links:


Forms for New Patients


Forms for Established Patients:

  • Patient Information Sheet  (Please fill out this form if there has been a change to any of the following: phone number, name, address, etc)

 
 Other forms:


Unicare

Community

Health Center, Inc.​

Appointments