302.855.1233

La Red Health Center

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New Patient Registration
All new patients must bring a picture identification to their first appointment. New patients are encouraged to download and complete the registration forms and application in advance of their first appointment as this will streamline the processing of paperwork at the time of the appointment and reduce the amount of time spent in our waiting room.
 
Please take the following steps to access our registration forms and applications:
 
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Step One - Download and Complete the New Patient Registration form
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Step Two - Download and Complete the Sliding Fee Scale Application
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La Red Health Center offers discounts on our service fees and on medical prescriptions costs to our uninsured patients. Our sliding fee scale is based on annually revised federal guidelines regarding income and family size. We offer discounts ranging from 20% to a flat nominal fee to those who qualify. In order to qualify for our sliding fee scale discounts, you must attach proof of income to the sliding fee application.
Patients who have medical insurance with high deductibles or reimbursement limits may want to consider applying for our sliding fee scale as well.
 
If you need a sliding fee scale from a previous year, please contact us at 302-855-1233
 
Acceptable forms of proof of income are copies of:
  • Two most recent pay stubs
  • Most Recent Federal Income Tax Return
  • Form 4506-T
  • Social Security/Disability Statements
 
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Step Three - Download and Read the Notice of Privacy Practices - Please DO NOT sign this form in advance of your appointment
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Step Four - Call to schedule an appointment.
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