Everyday: 8am - 8pm

Walk-ins Are Welcome

9695 Baseline Rd

Rancho Cucamonga, CA

(909) 941-0920

Got A Question Call Now

Patient Resources

Patient Intake Forms

At Central Urgent Medical Care in Rancho we care about your convenience. This is why we have revamped our patient intake forms and they are now fully editable PDF documents.  Simply download the form, edit it in your computer or mobile device and either print it or e-mail it to info@centralurgentcarerancho.com ahead of your visit.
If you do not have a PDF reader on your phone or computer, get the Free Adobe PDF Reader here. 

What to bring

  • Bring (or send in advance) your completed (filled out) patient form package.
  • Bring your insurance card and picture ID or Driver’s License.
  • Parent’s and/or Guardian’s must bring children’s insurance card and your picture ID.
  • Bring a list of all medications that the patient is taking.
  • We look forward to having you as a patient.

Health Tips

Consult your doctor to help you know and understand the following:

  • Keep your weight under control.
  • Know your blood pressure and strive to maintain it with-in normal limits.
  • Keep your cholesterol with-in normal limits.
  • Exercise daily for a longer and more vibrant life. Ask your doctor what type of exercise is recommended.
  • Eat small portions of food throughout the day, incorporate fruits, vegetables, protein, dairy & grains.