Prepare for Your Visit
1 What to bring to your first visit:
As a new patient, you will want to provide the health center with a detailed and honest medical history of your entire family.
All applicable medical documentation
Medications you are currently taking
Photo identification
Your health insurance card with a CenterPlace Health Provider listed as your Primary Care
Physician (if required by your insurance carrier to have a Primary Care Physician).Completed Release of Information Form
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2 Eligibility:
If you are uninsured and would like to apply for reduced fees for your visits, please bring the following items to check-in at your first appointment to determine Sliding Fee Scale Eligibility.
Picture ID (government ID, foreign government ID, or other ID with supervisor approval)
- Verification of most recent 4 weeks of total Gross Household Income*
- (Income is earnings/wages; self-employment income; commissions; tips; social security; supplemental security income (SSI); minor child SSI, alimony; workers compensation; estate or trust income; unemployment; rental income; VA benefit; interest/dividends; annuities; public assistance; child support; retirement/pension, educational assistance; gambling winnings, other financial assistance, and other sources of income that would be deemed taxable on an IRS tax return.)
- If verification of Gross Household Income is available, you may request a Letter of Support from the front desk at check- in.
Arrive 15 minutes early!
It’s good practice to arrive at least 15 minutes prior to your scheduled appointment. If you are a new patient, please arrive earlier so that you can complete new patient registration forms.
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