New Patient Forms and Information

We warmly welcome you to become a patient. We are committed to serving both insured and uninsured patients. We accept most insurance plans, including Medicare and Medicaid.

Our Patient Forms section below contains many of the forms that you may need during the course of your treatment at Foothills Community Health Care. In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

New patients need to bring:

• Picture ID and Social Security Card
• Insurance cards and co-payment amount
• Birth certificate and shot records for children
• Copy of medical records (if possible)
• Prescription medicine bottles
• 3 recent pay stubs or a notarized letter from employer for household income (for patients who qualify for our sliding fee discount)
• Appropriate sliding fee payment (for patients who qualify for sliding fee discount)

Foothills Community Health Care is dedicated to providing you with the highest quality, cost effective medical care. We accept all major credit cards and offer payment installments.