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Patient Forms

Patient Forms

PATIENT REGISTRATION FORM

FORMULARIO DE REGISTRO DE PACIENTES

Community Outreach Registration

School-Based Enrollment Form

Formulario de Inscripción basado en la Escuela

Slide Fee Scale Form

Work Verification Form

Request For Initial Visit (NEED)

CLYBURN CENTER FOR PRIMARY CARE

1000 Clyburn Place
Aiken, SC 29801

803.380.7000

M – Th : 8am – 7pm Friday : 8am – 5pm Sat*: 8am – 12pm (*Pharmacy Only)

MARGARET J. WESTON COMMUNITY HEALTH CENTER

4645 Augusta Road,
Beech Island, SC 29842

803.380.7000

M – F: 8am – 5pm

FAMILY HEALTH CARE

120 Darlington Drive, Aiken, SC 29803

803.380.7000

M – F: 8am – 5pm

WOMEN & CHILDREN’S HEALTH CENTER

995 Clyburn Place Aiken SC 29801

803.380.7000

M – F: 8 am – 5 pm Sat*: 8am – 12pm

Our mission is to provide accessible, quality, comprehensive primary healthcare services in a dignified and culturally-competent manner to the population in Aiken County and surrounding areas.

No one will be denied access to services due to inability to pay; there is a discounted/sliding fee schedule available based on family size and income.

Rural Health Services is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). This health center receives HHS funding and has federal Public Health Service (PHS) deemed status with respect to certain health-related claims, including medical malpractice claims, for itself and its covered individuals.

Juiced by M3 Agency

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