What Do I Bring?

List of documents patients need in order to obtain services at the clinic located in Lawrence, Kansas. 

What do I need to bring to Health Care Access?

  • Before you come in for an appointment, print and fill out all documents:

Filling these forms out before the appointment will reduce your wait time and get you in to see one of our nurse practitioners faster! 

  1. Registration Form (Click language to open form) - English / Spanish

  2. Medical history Form (Click language to open form) -  English / Spanish

  3. Patient Privacy Form (Click language to open form) - English / Spanish

  4. Consent to Treat Form (Click language to open form) - English /Spanish

View our brochure in English or Spanish


  • You will need to bring a form of identification 

Bring a valid identification card such as a drivers license

 

  • Proof of address 

A lease, utility bill, car registration or official document

 

  • You will need to bring in TWO months worth of pay-stubs or current taxes


What if I don't have all of these?

CALL us at: 1-785-841-5760 or stop by the clinic to discuss your eligibility. We'll help you figure out what your best options are.