Call us today at

1-800-258-7535

Registration Forms

To speed up the check-in process with AFC Pri Med, please click on the Registration Form below, complete all the information, and bring the completed form in with you.
Registration Form
HIPAA Notice Form
HIPAA Notice Form in Spanish

After you sign in, the front office personnel will request:

  • Insurance Card
  • Photo ID
  • Co-Pay

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