Please complete the form below. A Registration Services Specialist will contact you to complete your registration process and schedule your appointment.
If you are uninsured or underinsured, Care Resource also provides services on a sliding fee scale. Fees are based on family income and size for residents living within Care Resource’s service area. To see if you are eligible, click here
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.
