Applications & Forms

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.

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.