Patient Rights & Responsibilities
Respecting your rights is critical to providing you with the best possible care and therefore is an inherent part of our mission. These rights are fundamental and are intended to safeguard your personal dignity while a patient at Riggs Community Health Center (Riggs CHC).
At Riggs Community Health Center, we consider you the most important member of your care team. We rely on you to help us do what we do best -- care for people. Please review the following patient responsibilities so that you will understand our expectations.
New Patient Enrollment
At Riggs Community Health Center, all patients are welcome!
To enroll as a new patient at Riggs, come in during our normal business hours and speak to one of our Patient Service Representatives at the front desk.
To help expedite the enrollment process, please bring with you the following:
- Proof of identity (i.e. photo ID, passport, green card, or residency card)
- Social Security Card (only if you have been issued a valid Social Security card)
- Proof of mailing address (no handwritten addresses)
- Copy of correspondence with name and address received within the past 60 days (current utility or phone bill, or bank statement)
- Proof of current household income (please bring ALL that apply)
- One month of current pay stubs or letter from employer, stating number of hours worked and rate of pay
- One month of current unemployment stubs
- Most recent tax return
- IF NO INCOME, wage inquiry from unemployment office, along with a letter of support from the person assisting you with expenses
- Pension statements, school grants/scholarship information
- TANF-need letter from Medicaid stating amount received
- Social Security statements
- Disability statements
- Child Support statements
- Insurance Information
- Medicaid/Hoosier Healthwise card (if you have it)
- HIP Card (if you have it)
- Private insurance cards (if you have them)
- List of all medications you are currently taking
If enrolling a child as a new patient, also bring:
- Birth certificate or confirmation from hospital
- Immunization record
The following forms are also required for enrollment. You may print out the required forms and bring them with you, otherwise they will be provided by the Patient Services Representative at the front desk when you enroll.
- Riggs Consent for Treatment Form
Questions? Contact the Center
(765) 742-1567 or (800) 649-0390