We’re glad you are interested in becoming a patient at UCHC. Please take time to look at the documents below. They have important information about being a patient at UCHC.
For information or assistance applying for Insurance coverage, please visit our “Patient Resources” page.
Required Forms – Medical Services
Please complete forms thoroughly and bring them with you to your first appointment or email them to email@example.com.
Adult and Pediatric Forms
These forms must be completed for all patients.
Sliding Scale Discounts
You may be eligible for discounts, even if you are insured. If you would like to apply for our sliding scale discounts, please complete the form below and submit with all requested documentation.