If you are a patient 18 years of age or older you need to fill-out the adult demographic form.

See links below for English and Spanish versions.

If you have seen a doctor or specialist outside of EGHC please fill-out the medical records release form.

See links below for English and Spanish versions.

If you would like to participate in EGHC's sliding-scale fee program for people uninsured or under-insured, please fill-out the sliding scale fee packet below and bring your proof of income with you to your appointment. 

See links below for English and Spanish versions.

Don't forget to bring your insurance cards if you have insurance, a picture ID, and your proof of income (w-2, pay check stubs, letter from your employer, etc.) if you plan to participate in EGHC's sliding-scale fee program. Your income must be updated every year.