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PATIENT FORMS

 

Registration

Our PATIENT REGISTRATION FORM is now available online for you to complete before you come in. Having this form completed before arriving can save up to 20-30 minutes of waiting to be seen! To access the form, hit the link below (our Urgent Care House) and complete the form using your personal computer. Then PRINT and bring them with you! (Be sure to download and review the WAIVERS also.

At our clinic, we’ve simplified the payment process by securely keeping your credit card on file. Just focus on your health while we handle the rest seamlessly. It’s our way of ensuring smooth, stress-free payments for your care, all while safeguarding your information with the utmost confidentiality. Sit back, relax, and let us take care of both you and the billing!

HOW TO VERIFY YOUR INSURANCE

We have provided step-by-step instructions on how to verify your own insurance to ensure that our clinics are in-network with your health insurance policy. There is a CHECKLIST included with the instructions. This CHECKLIST is also part of the PATIENT REGISTRATION FORM.

Patient Registration Form

Medical Questionaire
Click the Icon to Download

Waivers for Your Records

Financial Policies/Waivers/Privacy
Click the Icon to Download

Insurance Instructions

Verification of Benefits
Click the Icon to Download

Medical Release Form

Medical Release Authorization
Click the Icon to Download

"We're here when you need us.”

Urgent Care

Caring For You & Your Family 24 Hours a Day, 7 DAYS A WEEK

caring family doctor holding a patient
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