New Patients call 866-234-8534 to schedule an appointment.
Self-Scheduling is available for Established Patients only.
Patient Forms
NEW PATIENT FORMS
PCMH BROCHURE – English
PCMH BROCHURE – Spanish
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 such as last three pay stubs or 1040 tax returns
- 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
English 
Spanish