Medical Registration:

New medical patients to HAHC need to complete the following forms for their first visit. Completing these in advance will help shorten your registration time. In addition to the forms, bring your current insurance cards, photo id, and all medications. If you will be applying for sliding fee also bring the sliding fee application and required proof of income. The sliding fee application is below.

Medical Registration Application | Record Release Form | Consent to Disclose Information

Dental Registration:

New dental patients to HAHC need to complete the following forms for their first visit. Completing these in advance will help shorten your registration time. In addition to the forms, bring your current insurance cards and photo id. If you will be applying for sliding fee also bring the sliding fee application and required proof of income. The sliding fee application and information is below.

Dental Registration Appplication | Record Release Form | Consent to Disclose Information

Sliding Fee Application:

Patients applying for the sliding fee will need to complete the following application and supply required proof of income. If you have any questions regarding the sliding fee please call the office.

Sliding Fee Application | Record Release Form | Consent to Disclose Information