New Patient Paperwork

Once you arrive at Quick Care, please be prepared to provide the following information. This will allow us to serve you more quickly.

• Patient and policy holder name, social security number, date of birth, address and telephone number
• Picture ID
• Current insurance card
• Your co-payment or deductible amount, if applicable, is requested at the time of service
• Your primary care physician's name
• List of your current medications, including over the counter and prescription