New Patient Paperwork
Welcome to the Carlinville Area Hospital and Clinics family. We are excited to be part of your healthcare journey. Please take a few minutes to fill out the appropriate new patient paperwork form below. Answer each question as completely as possible.
Adults - New Patient Paperwork
If the patient is over the age of 18, please complete the form linked below. The patient should bring their photo ID and insurance cards to the office on the day of their appointment.
Adults New Patient Paperwork FormPediatrics - New Patient Paperwork
If the patient is under the age of 18, a parent or legal guardian should complete the form linked below. If the child is a newborn, please ask the hospital where the child was born to send the medical records to our office.
Pediatrics New Patient Paperwork Form