‍Registration Process

Before your first appointment, you will be asked to complete forms to provide San Ysidro Health with the information needed to care for you.

To register, please download and complete the registration form below and bring it with you to your first San Ysidro Health appointment.

Download Registration Form

‍

You should also bring the following items to your first appointment:

• Driver’s license, valid passport, or other valid photo identification.

• If the address on your ID card or driver’s license is not current, you will need to provide a current utility bill, rental agreement, or bank statement that has your current address.

• Social Security Card, if applicable (social security numbers)
• Insurance I.D. card(s) showing group & policy number, if applicable
• Medicare and / or Medi-Cal card(s), if applicable

‍

Before your first visit, you will also be asked to fill out the forms listed below. To save time, you can fill out these forms before arriving for your appointment.

Adults (ages 18 and over):

Health Information Exchange Consent Form - English

Health Information Exchange Consent Form - Spanish

‍Consent to Treat Form- English & Spanish

Adult History Form- English & Spanish

‍DHCS Staying Healthy Assessment - English

‍DHCS Staying Healthy Assessment - Spanish

‍

Minors (under 18 years of age):

Health Information Exchange Consent Form - English

Health Information Exchange Consent Form - Spanish

‍Consent to Treat Form- English & Spanish

‍Pediatric History Consent Form- English & Spanish

‍

‍San Ysidro Health Discount Program

We offer a sliding fee scale! If you do not have medical insurance coverage and would like to apply for our Sliding Scale Fee Discount Program, which provides discounts for medical, dental, laboratory, x-ray, and pharmacy services to individuals that qualify, you should also bring the following items with you to your first appointment:

• If employed: a paycheck stub (at least one; must be recent) for all family members which are employed, or the previous year’s income tax return(s)
• If unemployed: proof of unemployment and/or proof of any other income

Please Note: San Ysidro Health’s discount program is available to all patients with or without insurance coverage at the time of their application.

‍

On-Site Support

Please see one of San Ysidro Health’s Certified Eligibility Specialists (CES) or Patient Services Representatives, located at your clinic’s registration desk, for details on:

• Discount programs
• Federal and state assistance programs (be specific if Medi-Cal, WIC, etc)
• Accepted insurance plans
• Photo identification requirements
• Registration assistance for minors (patients under 18 years old)
• English/Español bilingual assistance
• Sign language & foreign language interpreters
• And more.

Other Resources for New Patients

Patient Impact

At San Ysidro Health, we believe that healthcare is based on trust. We go above and beyond for the patients that choose us as their medical home.

Click here [link to Patient Impact section] to see some of our patient stories and learn more about what makes San Ysidro Health a provider of choice for 110,000 people across San Diego County.

Frequently Asked Questions

We also invite you to review our Frequently Asked Questions.

If you have a question that is not listed in this section, feel free to contact our Call Center by calling or texting (619) 662-4100.

Click to see our Frequently Asked Questions.

Glossary of Terms

Healthcare can be confusing. We hope you find our Glossary of Terms helpful as you navigate through our website.

‍