New Patient Information


New Patients

New Choptank Health Patient Information

New Patient Forms:

Click on any of the links below to download.

NEW PATIENT MEDICAL FORM ENGLISH

NEW PATIENT MEDICAL FORM SPANISH

NEW PATIENT MEDICAL FORM CREOLE


Thank you for choosing Choptank Community Health System for your healthcare needs. 

We look forward to partnering with you to deliver caring, comprehensive, and integrated healthcare to you and your family. We offer a wide range of services and specialties for all members of your family, including behavioral health, women’s health, and school-based health services. 

Choptank Health offers services to all, regardless of your ability to pay. We participate with Medicare, Medicaid, and many local insurance plans. If you do not have insurance and meet eligibility requirements, we offer a patient financial assistance program including a sliding fee.

Choptank Health has locations in Caroline, Dorchester, Kent, Queen Anne’s, and Talbot Counties.

Appointments can be made by calling any office.
If you are unable to keep a scheduled appointment, please call the office at least 24 hours before the scheduled appointment to reschedule or cancel.

 

After-Hours Medical and Dental Emergencies

Call 443-329-9920

After-Hours Behavioral Health Emergencies

Call 888-407-8018

Prescriptions Refills

Requests for refills on prescriptions ordered by your provider can be called in or left with the receptionist.

You may pick up your refill prescription or have it called in to your pharmacy.

For routinely prescribed medicines, an appointment is normally required with your provider every six months.

Please do not wait until you are out of your medication to request a refill.

Specialist Referral

If you need a referral from your provider to obtain specialty care, please make requestsfor non-urgent referrals at least 5 days before your appointment with the specialist.

Record Requests

All requests for forms to be filled out or medical records copied for other providers, work, school, insurance companies, social services, etc., will be completed within 10 working days of your request.

Interpretive Services

Spanish and Creole interpreters are available at some locations and access to LanguageLine Solutions is available at all our locations.