Care Resource provides services on a sliding fee scale. Fees are based according to family income & size for residents living 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: A photo ID must be uploaded with this form in order to process your registration. You may take a photo of your ID and other supporting documents, and upload as instructed below. If you have health insurance, please include photos of the front and back of the insurance card. If registering a minor for pediatric care, please attach a copy of the birth certificate and any other legal documents showing guardianship. As a patient of Care Resource, you may also qualify for discounted services with our sliding fee scale program. To see if you qualify, attach a copy of your most recent payroll stub.