Items to Bring:

• Your Photo Identification

• Your Insurance cards (if you don’t have insurance, please bring check stubs from your paychecks for 1 month of work OR bring your previous year’s tax return. This will help us to determine if you can qualify for our Sliding Fee Program)

• Your Immunization Records

• Your Medications OR a list of your current prescriptions

• Medical History (for example: if you have had any surgeries or special medical care)

• Verifications of your home address: (for example: you can bring a copy of your utility bill, etc.)

New Patient Forms

• Choose Your Primary Care Clinician

• Uniform Data System Information (English | Spanish)

• Patient Information (English | Spanish)

• Services Authorization (English | Spanish)

• Patient Financial Policy (English | Spanish)

• Acknowledgment of Receipt of Notice of Privacy Practices (English | Spanish)

• Notice of Privacy Practices (English | Spanish)

Call to schedule an appointment.

Items to Bring:

• Your Photo Identification

• Your Insurance cards (if you don’t have insurance, please bring check stubs from your paychecks for 1 month of work OR bring your previous year’s tax return. This will help us to determine if you can qualify for our Sliding Fee Program)

• Your Immunization Records

• Your Medications OR a list of your current Prescriptions

• Medical History (for example: if you have had any surgeries or special medical care)

• Verification of your Home Address (for example: you can bring a copy of your utility bill, etc.)

New Patient Forms

• Choose Your Primary Care Clinician

• Uniform Data System Information (English | Spanish)

• Patient Information (English | Spanish)

• Services Authorization (English | Spanish)

• Patient Financial Policy (English | Spanish)

• Acknowledgment of Receipt of Notice of Privacy Practices (English | Spanish)

• Notice of Privacy Practices (English | Spanish)

Call to shedule an appointment.