Instructions
BEFORE YOU BEGIN, please read our Becoming a Church Health Patient page. Once you’ve done that, complete this New Patient Information form. After submitting the form, you will be contacted for an appointment.
What to Bring
- Your photo ID
- Proof of residency (if not on photo ID)
- A list of all medications
- Money for your visit to pay co-pays or co-insurance costs
- Insurance card
- Proof of Income (if you do not have insurance)
For more information, please read our New Patient Requirements.