Patient Forms & Information

First Care Clinic utilizes an electronic check-in platform, Luma.

Prior to your appointment, using any smartphone, tablet, or computer, you can:

  • Confirm your appointment via text message or email
  • Securely register and pay your copay

 

A few days before your appointment you will receive a text message or email from Luma. Click the link provided and follow the simple on-screen prompts. From here you can pay your copay, update your medical information, or give us important information prior to your appointment. Doing so will save time when you arrive and enable us to attend to you sooner.

If you’re unable to complete your appointment registration before arriving, you’re welcome to complete them out at check-in. Please arrive at least 10 minutes early for your appointment if you need to complete the registration.

*Insured patients need to bring their insurance card along to their appointment.

Sliding Fee Scale

First Care Clinic accepts most major insurances, and services are provided on a Sliding Fee Scale for those who qualify.

Patients who wish to utilize the Sliding Fee Scale need to bring their proof of income and sliding fee payment to their appointment & must complete the Sliding Fee Scale Application below.

  • The sliding fee sale is based on household size and annual income.
  • The discount will apply to services received at First Care Clinic, but not those services or equipment purchased from outside our facility.

Patients who qualify for the Sliding Fee Scale Discount are expected to pay at the time of service.

Medical

· Slide A: $30.00

· Slide B: $50.00

· Slide C: $60.00

· Slide D: $70.00

· Slide E: Full fee

*There is no separate fee for nurse visits for blood pressure checks, labs, weight checks, or suture removals.

*Medical patients who utilize the Sliding Fee Scale receive a discount on all Family Planning services.

Speak to a staff member for pricing details.

Behavioral Health

· Slide A: $15.00

· Slide B: $25.00

· Slide C: $30.00

· Slide D: $35.00

· Slide E: Full fee

Preventative Dental

· Slide A: $50.00

· Slide B: $75.00

· Slide C: $85.00

· Slide D: $95.00

· Slide E: Full Fee

Basic Dental

· Slide A: $70.00

· Slide B: $95.00

· Slide C: $105.00

· Slide D: $115.00

· Slide E: Full Fee

*Dental patients who utilize the Sliding Fee Scale receive a discount on all other major dental procedures.

Speak to a staff member for pricing details.