Establishing yourself as a new patient at Compassion Health Care, Inc. has never been easier! It all starts with getting registered. Registration helps us correctly identify you and your past medical history so that we can give you the very best care you deserve.
We make it easy for you to fill out a patient registration packet online, a sliding scale fee application online, or a printable version of the patient registration packet that includes the sliding scale fee application.
Note: If you wish to print out the registration packet, the sliding fee application is optional. You only need to complete this part if you are in need of assistance paying for your healthcare.
View your right to receive a “Good Faith Estimate” of expected charges for non-emergency medical services here.
PATIENT REGISTRATION ONLINE
To make things even easier, we offer a quick and easy way to submit your patient registration application to any of Compassion Health Care, Inc.’s sites. Submissions are HIPAA compliant and encrypted.
ONLINE SLIDING FEE APPLICATION
Need help paying for services provided by Compassion Health Care, Inc.? The sliding fee scale allows us to offer a reduced fee to those individuals who qualify. Eligibility for the sliding fee scale is based on income and family size.
PRINTABLE PATIENT REGISTRATION PACKET
If you choose to fill out the printable form, please mail it to your preferred location:
Caswell Family Medical Center
439 US Hwy 158 West
Yanceyville, NC 27379
James Austin Health Center
250 W Kings Hwy
Eden, NC 27288
PAQUETE DE REGISTRO DE PACIENTE IMPRIMIBLE
Si elige completar el formulario imprimible, envíelo por correo a su ubicación preferida:
Caswell Family Medical Center
439 US Hwy 158 West
Yanceyville, NC 27379
James Austin Health Center
207 E Meadow Rd. # 6
Eden, NC 27288
NOTICE OF PRIVACY PRACTICES
Printable Notice of Privacy Practices that describes how medical information about you may be used and disclosed and how you can get access to this information.
STUDENT REGISTRATION FORM
If your child is not a patient of CHC, fill out the student registration form here if your child will be accessing health services through our Mobile School-Based Health Center.
PRINTABLE MEDICAL RECORDS RELEASE
The access or authorization for the release of health information allows patients to give consent for their medical records to be shared with other healthcare providers or entities. This ensures the coordination of care and supports referrals, treatment, or other services needed by the patient. The authorization protects patient privacy by complying with HIPAA regulations, ensuring that only the necessary information is released to the approved parties for the specific purposes outlined by the patient.
ONLINE MEDICAL RECORDS RELEASE
The online access or authorization for the release of health information allows patients to give consent for their medical records to be shared with other healthcare providers or entities. This ensures the coordination of care and supports referrals, treatment, or other services needed by the patient. The authorization protects patient privacy by complying with HIPAA regulations, ensuring that only the necessary information is released to the approved parties for the specific purposes outlined by the patient.