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Patient Registration Form - FastMed Urgent Care

Patient Registration Form - FastMed Urgent Care 2025

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The document is a Patient Registration Form for FastMed Urgent Care, requiring essential personal and insurance information from patients. It includes sections for patient details, emergency contacts, financial policies, consent for medical treatment, and acknowledgments of privacy practices and patient choice policy. The form emphasizes the importance of completing mandatory fields and outlines the financial responsibilities associated with medical services.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does urgent care take all types of insurance?

Not all urgent care clinics will be able to accept every type of health insurance, so it is also recommended that patients check with their nearby urgent care clinics to determine which insurance providers they are able to accept.

Can I use my Medicaid at urgent care?

Medicaid patients can access urgent care services without a referral, which means faster medical care for minor health issues like cuts, bruises, stitches, or X-rays. This direct access means they can seek care even when their regular doctors are unavailable.

Does FastMed Urgent Care take Medicaid?

What types of insurance does FastMed accept? FastMed accepts most major insurance plans, including Medicaid and Medicare.

What is on a patient registration form?

The information collected during patient registration includes personal details such as name, address, contact information, date of birth, social security number, insurance details, medical history, and any relevant medical conditions or allergies.

Does FastMed do walk-ins?

FastMeds services are designed around your lifestyle. We address a broad spectrum of primary care and urgent care needs. Whether you require immediate walk-in attention for an injury or illness, or are in need of a school or sports physical, we are here to help you.

How much is a dot physical at FastMed?

Our medical examiners are required to complete routine training every 5 years to maintain certification. FastMed follows all DOT regulations and standards. FastMed offers DOT physical exams starting at $109.

Can I go to CityMD with Medicaid?

CityMD accepts most major health insurances including Managed Medicaid, Medicare Advantage, and exchange plans.

Patient Registration Form - FastMed Urgent Care 2025

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