New Patient Registration

The Patient Registration process and online form provides us with the information to set up your billing account with ARC. Information required includes demographics of each patient, responsible part for payment, and any health insurance information applicable to the patient.

In collecting demographic information, ARC adheres to the standards that were established by the U.S. Office of Management and Budget (OMB) in 1997. It is the same standard used by the U.S. Census Bureau. The OMB requires five minimum categories for data on race:

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
  • White

The OMB requires two minimum categories for data on ethnicity: 

  • "Hispanic or Latino"
  • "Not Hispanic or Latino”

A patient's response to the race and ethnicity questions are based on self-identification and the patient may choose more than one race.

MyChart® Registration & Caretaker Forms

Visit the MyChart® Registration & Caretaker Forms page for more information on how you can sign up for MyChart® and how to also gain access to your child or loved one's medical information. MyChart® is ARC's easy-to-use patient portal that allows quick and easy access anywhere and anytime.

Patient Information and Consent for Treatment of a Minor

Please fill out a Consent to Medical Treatment of a Minor form and have your child bring it to the appointment if you are the parent of a minor and would like your child to be seen by any of our providers without your presence.

Release of Information (ROI) Forms

Please visit the Release of Information (ROI) page for more information and to find the ROI form that best suits your needs.  Whether you are a new patient requesting a transfer of your medical records to Austin Regional Clinic or an established patient requesting your medical records from ARC, a Release of Information Form is required.

Health History Forms

Health History forms are for basic background health information. It will be reviewed by your doctor and nurse as soon as it is received, is confidential and part of your medical record.

For your convenience we provide our patient forms online. Please bring the completed form with you to your appointment.