Patient Registration

Patient Registration Forms

Welcome to the Patient Registration page, where you’ll find patient registration forms and first appointment information.

Getting Started

Three steps to your first visit.

First, book your appointment

Before you complete any form, make sure you have called to book your appointment at one of our locations throughout the Greater Brazos Valley. Note that new patients cannot make online appointments or access the Patient Portal.

Already booked your first appointment?

Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so before your visit will help speed up the new patient registration process. If you have any questions about these forms, the front desk staff can help you.

Prepare for your first visit

For patients new to HealthPoint, the first visit includes an income screening. Review what to bring so your first appointment goes smoothly.

Already an established patient?

If you are an established patient already registered in our system, you may log in to the online patient portal to update your forms.

Registration Documents

Download & complete your forms.

English

Patient Registration Form

Español

Formulario de Registro del Paciente

English

HealthPoint Patient-Initiated Release of Medical Information Form

Español

Divulgación de Información Médica Iniciada por el Paciente

Please note: it may take a few minutes for the forms to load if you have a slow internet connection. If you cannot view the forms, you may need to download Adobe Acrobat for free.

Your First Visit

What to bring.

All Patients

For patients new to HealthPoint, the first visit includes an income screening to determine whether you or your family members are eligible for healthcare assistance programs such as Medicaid, CHIP, etc.

For your first appointment, please bring the following:

The completed forms you downloaded and printed from this web page
A list of your current medications
Any diagnostic films or other test results that may have been ordered or performed by another physician, if applicable
A driver’s license or photo ID
Your insurance card, if applicable (Medicaid, MAP, CHIP, other)

If you are uninsured and are not eligible for public assistance, the income screening also determines your fee for services based on a sliding fee scale according to Federal Poverty Level guidelines.

Uninsured Patients

Care regardless of your ability to pay.

As a Federally Qualified Health Center (FQHC), HealthPoint receives funds from the Health Resources & Services Administration (HRSA) Health Center Program to provide primary care services in underserved areas. As an FQHC, HealthPoint meets a stringent set of requirements, which includes providing services regardless of a patient’s ability to pay, charging for services on a sliding fee scale, and operating under a governing board that includes patients.

If you need medical care but cannot cover the cost, please refer to our Eligibility & Financial Assistance page to request an appointment with our eligibility team.