NEW PATIENTS

We appreciate your selection of one of our First Choice Community Health Centers to provide your medical and/or dental care. We are committed to providing you the best care available. To keep the cost of your care to a minimum, we will work together and ask that you read the following information. We look forward to serving you and your family.

All forms on this page are in a ".pdf" format, so you will need Adobe Acrobat to read and print them.

First Visit
Payment Policy
Walk In Patients
Late Arrival
Returned Checks
No Show
What to Bring to Your First Appointment
Transfer of Medical Records


FIRST VISIT

Please show up at least 30 minutes before your scheduled appointment so that we may complete all required paperwork.

Failure to do so may result in a longer waiting time on your visit.

Back to top


PAYMENT POLICY

All co-payments are due at the time of service. We do not bill for co-payments.

We accept checks, cash, American Express, Visa, and MasterCard. Payment plans are also available.

Any questions regarding your account should be directed to our billing office at (910) 364-0970, extension 1623.

Back to top


WALK IN PATIENTS

All First Choice Community Health Centers clinics accept walk-in patients for emergency and sick visits.

Back to top


LATE ARRIVALS

We will do our best to accommodate patients who arrive a few minutes late for their appointments. However, it may be necessary to re-schedule your appointment depending on the provider's schedule.

Back to top


RETURNED CHECKS

A fee of $35.00 will be added to the patient account for all returned checks.

Back to top


NO SHOWS

Patients who do not show up for an appointment without twenty-four (24) hours notification may be subject to a no show fee of $20.00.

Any patient who misses three appointments in a one year period without providing the twenty-four (24) hours prior notification may be placed in a probationary status and barred from scheduling future appointments. However, we will continue to see those patients on a Walk-In basis (please see above) until the one year probationary period ends.

Please ask us if you need further clarification on our policy.

Back to top


WHAT TO BRING TO YOUR FIRST APPOINTMENT:

  1. Completed Patient Data Form and Terms & Conditions
  2. Completed Tuberculosis Screening Form
  3. Completed Sliding Fee Program Application (if applicable - please refer to Sliding Fee)
  4. Completed HIPAA form specific to the center you are visiting (please refer to Privacy)
  5. All insurance cards including Medicare, Medicaid, HealthChoice, or private insurance
  6. A list of all medications you are currently taking
  7. Immunization records

If you have not already arranged for your medical records to be transferred, please do so as soon as possible (see instructions below).

Back to top


TRANSFER OF MEDICAL RECORDS FROM ANOTHER PROVIDER

If you are a patient who needs to have copies of medical records from a previous provider sent to a First Choice Community Health Centers Clinic, you can pick up a Medical Record Request form at any of our offices or click on this Form link and print a copy off.

Once you have it, please fill it out, sign it, and take it to your previous physician's office.

Back to top