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 – Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider’s or health care facility’s right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your health care provider or health care facility. A summary of your rights and responsibilities follows:
A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
A patient has the right to a prompt and reasonable response to questions and requests.
A patient has the right to know who is providing medical services and who is responsible for his or her care.
A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
A patient has the right to bring any person of his or her choosing to the patient-accessible areas of the health care facility or provider’s office to accompany the patient while the patient is receiving inpatient or outpatient treatment or is consulting with his or her health care provider, unless doing so would risk the safety or health of the patient, other patients, or staff of the facility or office or cannot be reasonably accommodated by the facility or provider.
A patient has the right to know what rules and regulations apply to his or her conduct.
A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
A patient has the right to refuse any treatment, except as otherwise provided by law.
A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.
A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, sex, gender, gender identity, sexual orientation, and source of payment.
A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.
A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.
A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
A patient is responsible for following the treatment plan recommended by the health care provider.
A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.