Intake Confirmation – New Patient

Thank you for choosing The Care Clinic!

    • Prepayment or insurance verification is required prior to confirming your appointment.
    • Paying out of pocket? (you may skip this if you have already paid through the intake form):
    • Using your Insurance?
      • We will verify your eligibility based on the insurance information submitted on your intake. Insurance acceptance varies from state to state. You can confirm that we are in-network with your plan here: . If we are out-of-network with your insurance, please check with your plan as you may be eligible for out-of-network reimbursement.

    • Our staff is working diligently to confirm a new patient appointment slot and will contact you within 24hrs to confirm. If you need an earlier appointment, please call us for same-day availability.


New patient appointment availability is based on clinic capacity, and is first come-first serve. If your matter is time sensitive, please complete the above as quickly as possible to secure an opening. Please call us if you have any questions or there is any way that we can assist you.

Thank you!


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