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We serve patients of all ages

Care Resource’s medical services are available to everyone. We care for men, women, teens, pre-teens and babies. Regardless of your legal status, ability to pay, gender, or age, count on our team to educate, guide, and care for your wellbeing.

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Patient Pre-Registration Form

Patient Pre-Registration Form

Care Resource provides services on a sliding fee scale. Fees are based according to family income & size for residents residing within Care Resource’s service area.

Please complete the short form below and click to submit this request to us. A patient service representative will contact you with an appointment time to complete your registration.

Note that support documentation may be required from you as part of the registration process (photo ID, proof of residence, insurance and income, etc.)

PLEASE DO NOT USE THIS FORM TO REQUEST A COVID-19 VACCINATION. REQUESTS MADE HERE FOR COVID-19 VACCCINATIONS ARE NOT ACCEPTED. INFORMATION REGARDING FUTURE COVID-19 VACCINATIONS AND APPOINTMENTS, WILL BE ANNOUNCED ON THE HOME PAGE OF THIS WEBSITE.

Patient Pre-Registration

Patient Name*
First Last
Patient Date of Birth (MM/DD/YYYY)*
Date Format: MM slash DD slash YYYY
Parent, Guardian or Caregiver (if different from patient name)
Patient Address:*
Street Address Address Line 2 City State ZIP
Phone*
Email*
Please select one:*
- New Patient
- Existing Patient (within 2 years)
- Past Patient (over 3 years)
Please indicate what kind of insurance coverage you currently have:*
- Medicare
- Medicaid
- Medicare & Medicaid - Dual Eligible
- Private or Commercial
- Public Insurance - (i.e. CHIP, Ryan White)
- Uninsured
Please select your preferred location:*
- Midtown-Miami
- Miami Beach
- Fort Lauderdale
- Little Havana
Please select the service you are requesting:*
- Covid-19 Testing
- Medical Services
- Dental / Dentist
- Therapy / Counseling
- Wellness / Preventative
- Housing Assistance
- PrEP / Pre-Exposure Prophylaxis
- nPEP / Post-Exposure Prophylaxis
- Other service(s) as described below
Consent*
I have read the Electronic Consent for Treatment and Financial Policy Acknowledgement and agree to the terms and conditions.
Name
This field is for validation purposes and should be left unchanged.

See our full list of health services by clicking on the link below or call 305-576-1234:

> Health Services

News

Information, events and news related to your healthcare

Introducing Curbside Waiting in Little Havana and Fort Lauderdale

Introducing Curbside Waiting in Little Havana and Fort Lauderdale

January 4, 2021

A Safe LGBT Workplace

A Safe LGBT Workplace

July 16, 2020

Adjusting to the New Normal

Adjusting to the New Normal

July 15, 2020

Be Prepared this Hurricane Season

Be Prepared this Hurricane Season

May 28, 2020

Coronavirus (COVID-19) FAQs

Coronavirus (COVID-19) FAQs

March 24, 2020

Confronting Uncertainty and Social Distancing During COVID-19

Confronting Uncertainty and Social Distancing During COVID-19

March 23, 2020

2018-2019 Annual Report

2018-2019 Annual Report

February 17, 2020

A Message on Suicide Prevention & Treatment

A Message on Suicide Prevention & Treatment

January 2, 2020

Building for the Future Together

Building for the Future Together

June 19, 2019

Remote Access with a Behavioral Health Counselor

Remote Access with a Behavioral Health Counselor

April 17, 2019

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Miami-Dade County

Midtown
3801 Biscayne Blvd.
Miami, FL 33137
T: 305.576.1234
F: 305.571.2020

Miami Beach
1680 Michigan Ave. Ste. 912
Miami Beach, FL 33139
T: 305.534.0503
T: 305.673.3555
F: 305.538.4090

Little Havana
1901 S.W. 1st St. – 3rd FL
Miami, FL 33135
T: 305.203.5230
F: 305.203.5231

Broward County

Fort Lauderdale
871 West Oakland Park Blvd.
Ft Lauderdale, FL 33311
T: 954.567.7141
F: 954.565.5624

Oakland Park
3160 Powerline Road
Oakland Park, FL 33309

FQHC Community Health Center Quality Award

The Joint Commission National Quality Leader

HRSA Health Center Quality Leader 2020

Guidestar Silver Seal of Approval

FTCA HEALTH CENTER This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).

REQUESTS FOR PROPOSALS Opportunities for vendors, contractors, and consultants to do business with Care Resource. Click Here

©2021 Care Resource Community Health Centers, Inc. DBA Care Resource does not discriminate on the basis of race, color, ethnicity, religious creed, age, sex, marital status, national origin, ancestry, sexual orientation, genetic information, physical or mental disabilities (including learning disabilities, intellectual disabilities, past/present history of a mental disorder), prior conviction of a crime (or similar characteristic), workplace hazards to reproductive systems, gender identity or expression, or other legally protected classifications in its programs and activities as required by the 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, and other applicable statutes and policies. Care Resource is a registered nonprofit. FEI #59-2564198.

IMPORTANT NOTICE:

PLEASE DO NOT USE THE PRE-REGISTRATION FORM TO REQUEST A COVID-19 VACCINATION. REQUESTS MADE USING THIS FORM WILL NOT BE ACCEPTED. INFORMATION REGARDING FUTURE COVID-19 VACCINATIONS AND APPOINTMENTS, WILL BE ANNOUNCED ON THE HOME PAGE OF THIS WEBSITE.

THANK YOU.

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