New Patient/Annual Forms:
We have gone mostly paperless. Please complete the required forms listed under Requirements in your Chargers Health Portal, or arrive at the clinic 15 minutes prior to your scheduled appointment to be sure paperwork is completed.
New Patient and Annual Clinic/Insurance Form
Before Your Appointment
To help ensure a smooth visit, please:
- ✔ Bring your current insurance card or upload your health insurance information to the Charger Health Portal.
- ✔ Complete all New Patient electronic forms under “Requirements” in the Charger Health Portal.
- ✔ Bring a photo ID.
- ✔ Verify that your insurance information is current.
- ✔ Understand your plan's copay, deductible, and coverage requirements. See Insurance & Billing for guidance.
- ✔ Contact your insurance company if you have questions about your benefits.
Other Forms:
Authorization to release healthcare information TO UAH