Patient Forms at Urgent Care and Walk-In Clinic in South Philly, PA

To speed up the check-in process with American Family Care, please click on the Registration Form below, complete all the information, and bring the completed form in with you.

Download or Print, Fill out the form and bring back to the clinic.

Registration Form
Registration Form For Returning Patients
Registration Form For Occupational Medicine/Workers’ Compensation
HIPAA Notice Form
HIPAA Notice Form in Spanish

After you sign in, the front office personnel will request:

• Insurance Card
• Photo ID
• Co-Pay (if applicable)