[!] Alert:

Alpena Services offers Acute Care Clinic hours six days a week - including Saturday mornings! Do you need a same day appointment for illness or injury? Check the Alpena Services location page for more info. Some same day appointments are available at all locations.

Forms

New Patient Forms – Please print, fill out and return by mail (or drop off) to the location that you will be using.

Alcona Health Center’s Registration form and Financial Policies

Medical Records Release

ADULT-Health-History-Form-9.21.18

PEDIATRIC-Health-History-Form-5.17.18

Sliding Fee Application – Please print, fill out and return by mail (or drop off) to the location that you will be using.

Sliding Fee Supporting Documents

Download Sliding Fee Application 2020

Download Sliding Fee For Self-Employed Application 2020 Only use this long version of the form if you or someone in your household is self-employed.