School-Based Health Center Registration
Providing convenient in-school medical, dental, and behavioral health care for students in Rockbridge County.
How to Register
To register as a new medical patient, please complete the printable patient application and applicable forms which include the following:
- Release of Information for transferring or releasing medical records (if applicable)
Financial Assistance Forms
- Sliding Fee Discount Program Application (If applicable)
- Statement of Support (For patients with no source of income)
- Income Verification Form (For patients that do not receive pay stubs)
- Self-Employment Verification Form (If applicable)
Print completed registration forms and deliver to your school nurse.