AFC West Chester

Patient Forms

CALL US TODAY | (484) 999-0204

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Contact us for up to date information

(484) 999-0204

Patient Forms at Urgent Care and Walk-In Clinic in West Chester, 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.

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
  • Your payment share for your visit. (Copay or Coinsurance)

Formerly AFC Doctors Express

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How Can We Help?

  • PATIENT SERVICES
  • COVID-19 SERVICES
  • TELECARE
  • EMPLOYER RESOURCES
  • PATIENT RESOURCES
  • ABOUT US
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Schedule Appointment

Schedule Appointment
AFC Urgent Care Logo Adhesive Bandage

Don't wait to get the medical attention you need.

CALL US TODAY | (484) 999-0204

About Our Services:

Call (484) 999-0204 for more information about our West Chester urgent care services.

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