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Becoming a New Patient

New Patient Registration & Medical Record Release Forms

We at Harbor Health Services, Inc. and all of our community health centers want to make the process of accessing healthcare as easy and as fast as possible for all of our new & first-time users. For NEW patients visiting one of our locations for the first time, it is best for you to download, print and fill out the four forms below before showing up for your scheduled appointment. This will allow you to check-in for your appointment with all of the necessary paperwork already being completed which allow our staff to provide you with FASTER service. If you have any questions about these forms please feel free to contact the Harbor Health site that you will be receiving care at.

Statement of Income
Notice of receipt of privacy practices
Patient consent to photograph
New Patient Registration Form

Medical Record Release

Medical Release Form