Items to bring to your first visit:
- Photo Identification
- Health insurance card(s)
- Social Security card
- Proof of income for sliding fee schedule discount
- Medical or dental history
- Medical records if you are new to the practice or have a recent hospital admission or emergency room visit
- To qualify for the sliding fee scale, you will need to bring income information including last three pay stubs or 4 paychecks
- List of medications currently taking and/or bottles of medication
- Foster parent or grandparent: Guardian or custody papers showing custody of child required
- Adult Guardian: Power of Attorney required
Appointments vs. Walk-ins
Appointments are preferred but are not necessary for urgent medical needs. If you would like to be seen without an appointment, please call or stop by the center. Often, you can be worked in between scheduled appointments with the first provider available. Patients with appointments will be seen first, except in situations of medical urgency.
New Patient Forms
PCMH Brochure – English
PCMH Brochure – Spanish
To better serve all our patients you have multiple ways to notify us if you are unable to keep your appointment. Please call our Call Center 866-234-8534 to notify us and reschedule your appointment or you can cancel via text by responding to your appointment reminder as directed.
A provider is on call when the Centers are closed. You can reach a doctor by calling 866-234-8534 and the answering service will contact the provider for you.
If you have an emergency, call 911 or go to the nearest hospital emergency room.
Fees and Insurance Accepted
Uninsured patients are offered discounted services through an income verification process. CFHC accepts Medicare assignment, Medicaid and MediPass, Florida Kid Care, and Healthy Kids, Workers Compensation, and other private insurance. CFHC also participates in a list of PPOs and a select list of HMOs. Such include, but are not limited to: WellCare, United Healthcare, Tricare, Three Rivers Network, Rockport Healthcare, Polk Healthcare, Netpass, Medicare Railroad, Medicare, Focus Healthcare w/c, First Health Network, HealthEase, Citrus HealthCare, Blue Cross/ Blue Shield W/C, Blue Cross/Blue Shield, Beech Street, Amerigroup. Your questions will be gladly answered regarding our participation with your insurance carrier. Payment of your medical/ dental visit is expected at the time of service.
Patient’s Rights and Responsibilities – You have a right to . . .
- To know what your rights and responsibilities are in receiving care.
- To be treated with courtesy and respect, with appreciation of your individual dignity, and with protection to your need for privacy.
- To a prompt and reasonable response to questions and requests.
- To retain and use personal possessions unless such use infringes on personal or other’s safety.
- To know who is providing services and who is responsible for your care.
- To know what rules and regulations apply to your conduct.
- To refuse any treatment.
- To know what patient support services are available, including whether an interpreter is available, if you do not speak English.
- To be given information from the provider relating to diagnosis, planned course of treatment, alternatives, risks and prognosis.
- To express grievances regarding any violation of your rights, as stated in Florida law, through the grievance procedure of CFHC and to appropriate state licensing agencies.
- To be given, upon request, full information and necessary counseling on the availability of known financial resources for your care.
- To know whether a health care provider accepts Medicare assignment.
- To receive, upon request and prior to treatment, a reasonable estimate of the charges for care. To receive a copy of a reasonably clear and understandable, itemized bill, and upon request, to have the charges explained. You can expect information about pain and relief. Expect staff to listen to your complaint of pain.
- To impartial access to treatment regardless of race, national origin, religion, physical handicap, or source of payment.
- To treatment for any emergency condition that will deteriorate from failure to provide treatment.
- To know it medical treatment is for purposes of experimental research and to give your consent or refusal to participate in such research.
It is your responsibility . . .
- To report unexpected changes in your condition to the provider.
- To report whether you understand the treatment plan.
- To follow the treatment plan recommended by the provider.
- To keep appointments and when unable to do so, to notify CFHC.
- To accept responsibility for your actions if you refuse treatment or not follow the provider’s instructions.
- To ensure that the financial obligations of your care are fulfilled as promptly as possible.
- To follow facility rules and regulations affecting patient care and conduct.
- Walk-in patients are welcome. Please call ahead so CFHC’s staff can be better prepared to treat you.
- Report any areas of concern to staff that you may have regarding patient safety. To call your pharmacy 48 hours in advance for refills.