New Patients

What to bring to your first appointment

• If you have insurance, please bring your insurance card or other proof of insurance.
• If you do not have insurance, please contact our Enrollment Counselors BEFORE your first visit.
  • Bring proof of income, such as  pay stub, income tax form, letter from employer
  • For Sliding Scale discounts, please bring proof that you live in Marin County
• Download, print and fill out the following forms and bring them to your first appointment.
  • Patient Registration (English) / Patient Registration (Spanish)
  • Authorization for Release of Information Form (English) / (Spanish)
  • Patient Questionnaire (English & Spanish)
  • Notice of Privacy Practices (English) / Aviso De Practicas De Privacidad (Spanish)
  • Acknowledgement of Receipt of Privacy Notice (English) / (Spanish)
  • Caregiver’s Authorization Affidavit (English) / Declaración Jurada de Autorización para el Cuidador (Spanish)
  • Authorization for Third Party to Consent to Treatment of Minor Lacking Capacity to Consent (English & Spanish)
• A list of prescription medications, and over-the-counter medications, remedies and herbs that you are currently taking; if possible, please bring medication bottles.
• Bring any test results or immunization records you may have had elsewhere, and glucometer, blood sugar readings log, blood pressure log, or nutritional log, etc.
• Please arrive 30 minutes before your first scheduled appointment.

Making the Most of a Phone or Video Visit

• Before your visit, please have your prescription medications. For video visits, please have a WifI connection and device with a camera.
• If you are the parent or legal guardian of a patient who is a minor or a dependent, please make sure the patient is present.
• Please turn your ringtone on and be in a private, safe space with little distractions (ex: avoid traveling in a car).
• Please be available 30 minutes before or after your scheduled appointment time, and note that call may come from a blocked caller ID.

Marin Community Clinics accepts the following insurance plans:

Government Insurance Programs

Medi-Cal, including special programs for pregnant women and family planning services. Call (415) 448-1500 for details.
Medicare
Path to Health
Connect to Care

Covered California

Private Plans purchased through Covered California:

Health Net
Anthem Blue Cross

You may enroll in Medi-Cal anytime. Our enrollment counselors can help you determine if you are eligible, and assist you with your application.

If you don’t qualify for Medi-Cal, you may be able to buy private insurance through CoveredCA.com.

Marin Community Clinics has trained Enrollment Counselors available to help.

• Call our Main Line and ask for Insurance Help at (415) 448-1500
• Email us at insurancehelp@marinclinic.org

If you do not have health insurance:

• Your visit fee may be discounted on a sliding scale, based on family size and income, according to federal guidelines. If you meet all of these qualifications:
  • Your family income is at or below 200% of federal poverty level
  • You have no health insurance coverage
  • You are not eligible for any government health insurance program, and
  • You are a Marin County resident
• Our staff will assist you in determining if you qualify for a discount; if you do, they will also assist you with the application. As part of this process, they will ask you to provide information about your family and your financial resources.

If you are covered by health insurance:

• Please look at the “Insurance Plans” tab to see if we can accept your insurance.

If you are not eligible for a discount and do not have insurance:

• There still may be some programs available to you. Our staff will assist you.
• If there are no other programs available to you, you will be charged a full fee. For example, you will be charged a minimum of $185 plus cost per medical visit and a minimum of $250 plus cost per dental visit.

• Payment for services is required at the time of your visit.
• Cash, check, debit cards or credit cards are all acceptable methods of payment.

Call our billing department at (415) 798-3110 for more information.

• At your first visit, you will be asked to select a Primary Care Provider – the medical professional that you will usually see and who will coordinate your care.
• Our front desk staff can assist you in choosing your provider when you arrive. To read more about our providers, see Our Health Care Team.
• At your first visit, you will be given access to our online Patient Portal where you can email your doctor, request appointments online, access your medical record, programs for pregnant women, and more. For your security, this access can only be granted in person.