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Patients

Patient Registration Form

NEW PATIENT REGISTRATION FORM

  • English (.pdf)
  • Spanish (.pdf)
  • HOW TO BECOME A SARHA PATIENT:

    If you or a family member are interested in becoming a new patient at one of our SARHA Medical Centers, please complete the New Patient Form (see links above) and then fax or mail the completed form to your chosen location. New patients may select a provider from any provider who is accepting new patients.

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