Easy Registration Begins Here!

For New Patients

Establishing yourself as a new patient at CFMC has never been easier! It all starts with getting registered. Registration helps us correctly identify you and your past medical history so that we can give you the very best care you deserve.

We make it easy for you to fill out a patient registration packet online, a sliding scale fee application online, or a printable version of the patient registration packet that includes the sliding scale fee application.

Note: If you wish to print out the registration packet, the sliding fee application is optional. You only need to complete this part if you are in need of assistance paying for your healthcare.

PATIENT REGISTRATION ONLINE

To make things even easier, we offer a quick and easy way to submit your patient registration application to CFMC or JAHC. Submissions are HIPAA compliant and encrypted.

ONLINE SLIDING FEE APPLICATION

Need help paying for services provided by CFMC and JAHC? The sliding fee scale allows us to offer a reduced fee to those individuals who qualify. Eligibility for the sliding fee scale is based on income and family size.

PRINTABLE PATIENT REGISTRATION PACKET

If you choose to fill out the printable form, please mail it to your preferred location:

Caswell Family Medical Center
439 US Hwy 158 West
Yanceyville, NC 27379

James Austin Health Center
207 E Meadow Rd. #6
Eden, NC 27288

PAQUETE DE REGISTRO DE PACIENTE IMPRIMIBLE

Si elige completar el formulario imprimible, envíelo por correo a su ubicación preferida:

Caswell Family Medical Center
439 US Hwy 158 West
Yanceyville, NC 27379

James Austin Health Center
207 E Meadow Rd. # 6
Eden, NC 27288