Medical & Dental Sliding Fee Application
- General Consent for Treatment
- Notice of Privacy Policies
- Patient Medical History
- Patient Registration
- General Consent for Treatment (Spanish)
- Notice of Privacy Policies (Spanish)
- Patient Medical History (Spanish)
- Patient Registration (Spanish)
New Patients Welcome!
Schedule an appointment today!
No Appointment Needed
Payment / Insurance
We accept most Major Health Insurance Plans, Medicare, Medicaid, Blue Cross Blue Shield, & United Healthcare & more. Please contact us with questions.
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Our Mission Statement
"MERCE Family Healthcare is a non-profit organization that seeks to provide primary medical and dental services, as well as the coordination of additional support resources to medically and dentally underserved citizens of Randolph County and the surrounding area."
NOTICE TO PATIENTS: This practice serves all patients regardless of their inability to pay. Discounts for essential services are offered based on family size and income. For more information, please ask the front desk staff at any of our locations.