How to Make an Appointment

Call your nearest Coastal Health Alliance Community Health Center. Phone numbers and open hours are listed at the end of this list.

Please arrive 15-20 minutes before your scheduled appointment time. There may be a form or application to fill out in order to enroll in one of our many insurance programs. These forms/applications must be completed before seeing a medical provider. Forms are available online for you to download, print out and fill out before your visit. Filling these forms out before you come to your visit may lessen your wait times.

Notice of Privacy Practices forms: english / spanish

Print, fill in and bring with you:

• Patient registration form : english / spanish

Payment Policy
Co-pay, insurance holders:

• A signed Payment Policy form: english / spanish

• Your co-payment or method of payment. Cash, check, debit cards or credit cards are all acceptable methods of payment and due at time services are rendered.

• Your insurance card or evidence of insurance.

• Any change in address and telephone number.

Low income payment assistance:

• You may qualify for one of our numerous low income programs, please read, print, fill out and bring to your appointment an eligibility for sliding scale form: english/spanish

• Proof of income: acceptable proof of income includes:  Copy of a check stub less than 30 days old, signed statement from employer (if paid in cash), alimony check, W2 form from your most recent Tax Return, workers compensation check stub, SDI, Social Security check stub, and pension check stubs.  We cannot approve your low income payment assistance without one of these proofs of income.