Foothills Community Health Care

We warmly welcome you to become a patient. Our Patient Forms section below contains many of the forms that you may need during the course of your treatment at Foothills Community Health Care.

New patients need to bring:

Picture ID and Social Security Card
Insurance cards and co-payment amount
Birth certificate and shot records for children
Copy of medical records (if possible)
Prescription medicine bottles
3 recent pay stubs or a notarized letter from employer for household income (for patients who qualify for our sliding fee discount)
Appropriate sliding fee payment (for patients who qualify for sliding fee discount)

Patient Forms

Please complete the following forms prior to your visit.

Registration and Information Child (under age 18) Privacy Policy

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Por favor complete los siguientes formularios antes de su visita.

Inscripción e Información Niño (menor de 18 años) Política de privacidad

We are committed to serving both insured and uninsured patients. We accept most insurance plans, including Medicare and Medicaid. In order to register and treat you promptly, we request that our patients bring their current insurance information with them for each visit.

Policies and Procedures

Policies and procedures are provided for patients of Foothills Community Health Care. Please contact us if you have questions or need any additional information. We are happy to assist you

No Show Policy Privacy Practices SCHIEx-Notice of Participation

Foothills Community Health Care is dedicated to providing you with the highest quality, cost effective medical care. We accept all major credit cards and offer payment installments.

Patient Information

Patient Forms

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Policies and Procedures