New Patient Registration Forms
- New Patient Informational Guide English (PDF) | Spanish (PDF)
- Sliding Fee Application English (PDF) | Spanish (PDF)
- Notice of Privacy Practice Booklet English (PDF) | Spanish (PDF)
- Patient Rights and Responsibilities English (PDF) | Spanish (PDF)
Printable New Patient Registration Forms
- New Patient Registrations Forms English (PDF) | Spanish (PDF)
- Release of Information Form English (PDF) | Spanish (PDF)
- Dental Patient Registration Form (Existing EDCHC Patients) English (PDF) | Spanish (PDF)
- Dental Patient Registration Form (Non EDCHC Patients) English (PDF) | Spanish (PDF)
- Current medications and/or vitamins
- Current insurance coverage cards
- Previous medical records & doctor information
- Immunization Records
- Any legal medical paperwork including, advanced directives and guardianship
EDCHC Patient Portal
The Patient Portal is a secure, convenient, and easy way to access your health information
Here’s what you can do with our portal –
- Communicate with your provider
- Get reminders
- Manage your appointments
- Access your test results
- View your medications and request refills
Launch Patient Portal
Patient Portal Instructions
