[!] Alert:

Masks or face coverings are required to enter our facilities. To learn more, click on the Covid-19 Alerts page.

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

Sliding Fee Application 2020