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Patient Information

Primary Care Office

At your Primary Care visit, you will be required to complete the following forms. All forms are available right here to fill out prior to your appointment. Click the links below for access to each form. 

 
Patient Application

Patient Release of Information for Patient Records to be Received by UFHC

Patient Release of Information for Patient Records to be Requested by UFHC

Authorization for Access to Patient Info Through Regional Health Info Exchange Database

FULL New Patient Packet

Co-Payment

Our office accepts all forms of payments to include cash, check debit and credit card options. Please make sure if you have a co-pay, you have it with you at the time of your appointment.

 

School-Based Locations
Students must attend Donovan Middle School, MLK Elementary, Kernan Elementary, Waterville Central School District, and Adirondack Schools to be eligible to receive services at the School-Based Health Center.

Parents must complete an enrollment packet below to register their child.

Enrollment Packet


For more information about our School-Based Health Centers, view our brochure below. 
School-Based Health Center Brochure 

Please see our 'Sliding Fee' page for information on paying for your visits.

What do I bring to my appointment?

Driver's License or Gov't ID

Insurance Card
All of your medication bottles or medication list
Immunization Records

Co-Pay (credit, debit, cash or check)

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