New Patient Registration

Thank you for choosing St. Francis Urgent Care Center. Our entire staff is dedicated to helping you maintain good health by providing you with quality care during you visit.

To make your first visit as stress-free as possible we have prepared the various forms we need in our New Patient Information Packet including:

  • Patient Registration Form
  • Purpose for Patient Visit
  • Detailed Health History
  • Notice of Privacy Practices

To minimize your time in our office, please complete these forms prior to your appointment and

Bring these forms to our office for your first appointment or

email these forms to: registration [at] stfrancisurgentcare [dot] com prior to your visit or

fax these forms to (510) 244-3655 prior to your visit.

We look forward to your visit and the opportunity to discuss any health concerns you may have.