Patient Resources
Everything You Need for Your Visit
Quick Access
Insurance & Billing
Insurance information, billing questions, and payment
Patient Forms
Download and complete forms before your visit
Preparation Guide
How to prepare for your visit and what to bring
Health Education
Health information and educational resources
Insurance & Payment Information
PPO Plans Accepted
- Blue Cross Blue Shield
- Aetna
- Cigna
- Humana
- United Healthcare
- Anthem
- All major PPO plans
Government Insurance
- Medicare
- Medicaid
- TRICARE
- Workers’ Compensation
Self - Pay Options
Common Self-Pay Rates
Office Visit: $100
School/Sports Physical: $30
Flu Shot: $40
X-Ray (additional): $75
Stitches (additional): $150
Patient Forms
New Patient Forms
Adult New Patient Package
Forms Included: -Patient Registration Form-Medical History Questionnaire-InsuranceInformation Form-HIPAA Privacy Notice-Consent for Treatment
Download Links: – English Version (PDF) – Spanish Version (PDF)
Pediatric New Patient Package
Forms Included: – Pediatric Registration Form – Child Medical History – Parent/Guardian Information – Immunization Records – Emergency Contact Form
Download Links: – English Version (PDF) – Spanish Version (PDF)
Specialty Forms
Occupational Health Forms
School & Sports Forms
Women’s Health Forms
Form Submission
How to Submit
- Bring completed forms to your appointment
- Email: forms@clincaurgentcare.com
- Fax: (872) 267-7957
- In-person: Drop off before your visit
Form Requirements
- Complete all required fields
- Sign and date all forms
- Include insurance card copy
- Bring photo ID
Preparing for Your Visit, What to Bring
What to Bring
Required Items
- Photo ID (driver’s license, state ID, passport)
- Insurance card (if applicable)
- Payment method (cash, card, HSA)
- Completed forms (if downloaded in advance)
Helpful to Bring
- Current medication list (including dosages)
- Previous medical records (if relevant)
- Symptom diary (when symptoms started, severity)
- Emergency contact information
Before You Arrive
Call Ahead (Optional)
- Check current wait times
- Verify insurance coverage
- Ask about specific services
- Get directions if needed
Complete Forms
- Download forms from our website
- Fill out completely and accurately
- Sign and date all required sections
- Make copies for your records
What to Expect
Check-In Process
- Arrival: Present ID and insurance card
- Registration: Complete any remaining forms
- Triage: Brief assessment by nursing staff
- Wait: Comfortable waiting area with amenities
- Treatment: See provider for examination and care
Typical Visit Timeline
- Check-in: 5-10 minutes
- Wait time: 15-30 minutes average
- Provider visit: 15-45 minutes depending on needs
- Checkout: 5-10 minutes
Special Considerations
For Pediatric Visits
- Bring comfort items for children
- Have immunization records available
- Prepare child for the visit
- Bring snacks and entertainment
For Occupational Health
- Bring work-related documentation
- Know your job requirements
- Have employer contact information
- Understand testing requirements
For Physicals
- Fast for 8-12 hours if blood work needed
- Bring previous physical results
- List any concerns or symptoms
- Know family medical history
Health Education Resources
Common Conditions
Cold & Flu Prevention
- Symptoms to watch for
- When to seek care
- Prevention strategies
- Home care tips
Minor Injury Care
- First aid basics
- When stitches are needed
- Wound care instructions
- Signs of infection
Chronic Disease Management
- Diabetes care
- High blood pressure
- Asthma management
- Heart health
Preventive Care Information
Annual Physicals
- What to expect
- Recommended screenings by age
- Preparation instructions
- Follow-up care
Immunizations
- Vaccine schedules
- Travel vaccines
- Flu shot information
- Side effects and safety
Women’s Health
- Reproductive health
- Contraceptive options
- Pregnancy care
- Preventive screenings
Occupational Health Education
DOT Physical Requirements
- Medical standards
- Preparation tips
- Common disqualifiers
- Appeal process
Workplace Safety
- Injury prevention
- Ergonomic tips
- Safety equipment use
- When to seek care
Pediatric Health Resources
Child Development
- Milestone tracking
- Nutrition guidelines
- Safety tips
- When to call the doctor
School Health
- Required immunizations
- Sports participation
- Managing chronic conditions
- Emergency action plans
Bilingual Resources
Bilingual Resources
Available Languages
- English: All staff and resources
- Spanish: Bilingual medical providers and translated materials
Translation Services
- Medical interpretation during visits
- Translated patient forms
- Bilingual health education materials
- Cultural competency in care delivery
Communication Assistance
- Clear explanation of medical terms
- Written instructions in preferred language
- Follow-up communication support
- Family member interpretation when appropriate
Digital Tools
Online Services
Patient Po rtal (Coming Soon)
- View test results
- Request prescription refills
- Schedule appointments
- Access medical records
Mobile App Features
- Check wait times
- Complete pre-registration
- Access health resources
- Find directions
Telehealth Options
Virtual Consultations
- Follow-up visits
- Prescription refills
- Health education
- Non-urgent consultations
Emergency Information
When to Call 911
- Chest pain or heart attack
- Difficulty breathing
- Severe injuries
- Loss of consciousness
- Stroke symptoms
- Severe allergic reactions
When to Visit Urgent Care
- Minor injuries and illnesses
- Cold, flu, fever
- Cuts requiring stitches
- Sprains and strains
- UTIs and infections
Emergency Contacts
- Clinica Urgent Care:(872) 267-7956
- Emergency Services:911
- Poison Control:1-800-222-1222
- Mental Health Crisis:988
Testimonials
What Our Patients Are Saying
4.9 / 5
Ratings
Lisa Wallace
CEO & Founder
From my child’s ear infection to my own flu symptoms, Clinica Urgent Care handled it all with care. Their pediatric urgent care was fast and gentle, and I loved not having to…
Hannes Wettstein
CEO & Founder
I walked into Clinica Urgent Care in Pasadena without an appointment and was seen within 15 minutes. The staff was incredibly friendly, and the provider explained everythin…
Roberto Martins
Architect
I walked into Clinica Urgent Care in Pasadena without an appointment and was seen within 15 minutes. The staff was incredibly friendly, and the provider explained everything…
Diane Iverson
Customs Officer
Opening & Closing Times
We are dedicated to providing
flexible & accessible healthcare
services.
- Monday - Friday 8AM - 8PM
- Coming Soon
