For New Patients to HealthReach
To establish care at your local health center, please fill out the
Authorization to Disclose Health Care Information form. This authorization allows HealthReach to retrieve your patient's medical records from your prior primary care provider. If you do not currently have a primary care provider, we still ask that you complete the
Authorization to Disclose Health Care Information form to give HealthReach permission to retrieve any existing medical records. Once this form has been completed, please mail or fax to the health center of your choice - for your convenience, all of our local health centers are listed at the bottom of these instructions.
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If you or someone in your family is a
new patient, you must also coplete the
General Consent to Treat form. Please choose the form that corresponds to your age/preferred language or the age/preferred language of the family member who will be a new patient. Once you have completed this form, please mail or fax to the health center of your choice listed below.
English:
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En Español:
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Below, you will also find HeathReach's
Patient Bill of Rights and Responsibilities; and the
HealthReach Notice of Privacy Practices in both English and Spanish. These are informational only and do not need to be returned.
English:
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En Español:
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Through funding from the U.S. Bureau of Primary Health Care, we also offer an
Affordable Care Program. This program reduces the amount you pay for health center services based on your income and family size. We have provided the Affordable Care Application below. For additional information, please visit the
Affordable Care Program information portion of our website.
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Your local health center may also request additional forms be completed. These forms will be provided to you either before or at your first appointment.
HealthReach Community Health & Dental Center Locations
Belgrade Regional Health Center
4 Clement Way, Belgrade, ME, 04917-4370 | Directions
Tel: (207) 495-3323
Fax: (207) 495-3353
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Bethel Family Health Center
32 Railroad Street, PO Box 1367, Bethel, ME, 04217-1367 | Directions
Tel: (207) 824-2193
Fax: (207) 824-3005
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Bingham Area Health and Dental Center
237 Main Street, PO Box 746, Bingham, ME, 04920-0746 | Directions
Tel: (207) 672-4187
Fax: (207) 672-3641
🦷 Dental Center
Tel: (207) 672-3519 Fax: (207) 672-3641
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Bulldog Health Center
(School-Based Health Center at Lawrence High School)
9 School Street, Fairfield, ME, 04937| Directions
Tel: (207) 861-9666
Fax: (207) 495-3353
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Lovejoy Health Center
7 School Street, Suite 1, Albion, ME, 04910-6501 | Directions
Tel: (207) 437-9388 Fax: (207) 437-2557
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Madison Area Health Center
8 South Main Street, PO Box 120, Madison, ME, 04950-4501 | Directions
Tel: (207) 696-3992
Fax: (207) 696-3974
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Mt. Abram Regional Health Center
25 Depot Street, Kingfield, ME, 04947-4208 | Directions
Tel: (207) 265-4555
Fax: (207) 265-5004
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Rangeley Family Medicine
42 Dallas Hill Road, PO Box 569, Rangeley, ME, 04970-0569 | Directions
Tel: (207) 864-3303
Fax: (207) 864-2969
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Richmond Area Health Center
24 Gardiner Street, Richmond, ME, 04357-1336 | Directions
Tel: (207) 737-4359
Fax: (207) 737-4412
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Sheepscot Valley Health Center
47 Main Street, PO Box 207, Coopers Mills, ME, 04341-0207 | Directions
Tel: (207) 549-7581
Fax: (207) 549-3439
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Strong Area Health and Dental Center
177 North Main Street, Strong, ME, 04983-3005 | Directions
Tel: (207) 684-4010
Fax: (207) 684-3368
🦷 Dental Center
Tel: (207) 684-3045 Fax: (207) 684-3049
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Western Maine Family Health Center
16 Depot St, Suite 300, Livermore Falls, ME, 04254-1311 | Directions
Tel: (207) 897-4345
Fax: (207) 897-2321 |
Questions?
Contact your local health center for more information.