If you have access to a printer, please download and print the applicable forms from this page before your first appointment.
Additional Reminders:
Arrive 15 minutes early for your appointment.
Bring your completed forms, Drivers License and insurance card, OR income verification information to your appointment.
Payment will be collected at your appointment. We accept cash, check, credit/debit, Flexible Spending, and Healthcare Savings Account cards.
If you are using sliding scale payment, please download and print the application to find out if you qualify and how to apply. Only prior-authorized individuals will be granted sliding scale rates.
If you are being referred by an approved LHCC Partner church or other organization and wish to receive our partner rates, you must bring a hard copy of a completed Partner Referral Form to your first appointment, or send by email to admin@lhcc217.org or secure fax to (217) 698-7085 prior to your first appointment.