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Welcome to the New Patient Packet page.

This is your New Patient Packet.

Get comfortable because there are some forms you need to fill out, so that we will have the most up-to-date information about you and your history.

Some forms you will need to sign and return to us. 

Here’s what you need to do to help us serve you better:

• Sign the HIPAA form

• Complete and sign the Authorization to Release Health Care Information

• Complete and sign the Registration form

• Complete and sign the Health History form

• Return the above documents to us: mail them, drop off at our office, or bring with you when you come but please arrive early.

Please bring the following items to your first visit:

• Photo ID

• Insurance Card, if you have one

• Co-pay (we accept cash, checks, and credit cards)

Thank you for choosing HOMETOWN Health Center. Our promise to you is that you will receive the best health care possible. 

Welcome Letter

Registration Form

Health History

Authorization to Release Health Care Information

HIPAA Signature Form 

HIPAA Notice Form 

Sliding Fee Scale Chart 

Missed Appointment Policy