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New Patient

If you’re a new patient at East Texas Community Health Services, feel free to download our New Patient Information Packet below and fill it out at your convenience and bring it in with you your first visit.

 

 

New patients will also need to complete our Application for Health Care Assistance (Adobe PDF Format  –  MS Word Format) and bring it in along with proof of your annual household income to your first visit. This means proof of the income of all wage-earners who live with you. This might include a copy of your and/or your family member’s most recent 1040 tax return form, copies of 2 recent pay check stubs, or a recent letter from an agency that gives you financial support, such as DSHS, SSI, or Unemployment.

 
 
 
NOTE: You will need Adobe Reader (available free from Adobe Systems)