Patient Information

Improving lives and helping our patients live healthier happier lives.

Everyone is Welcome
at Cornerstone

You’ve made an important choice by choosing Cornerstone Family Healthcare for your care. We are dedicated to meeting your healthcare needs and providing you with a comfortable experience. Our goal is to understand your medical needs, provide excellent healthcare and a reassuring environment, and see you through to a full recovery. When you need us, we’re here.

Patient Documents and Forms

Before your appointment with, quickly and conveniently access patient forms below. Please bring your completed forms with you to our office at the time of your visit.

Note: To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com.

New Patient
Help us get to know you better by filling out your medical form.
Patient Information​

Consent forms and documents to help you understand your rights.

Privacy Practices​

Important information about our privacy practices.

NYS Health Resources​

Review enrollment periods and low cost health insurance plans.

WIC​

Please review the WIC Complaint Forms here.

Additional Forms​

Health related forms such as consent, patient representation, and more.

Insurance & Healthcare Costs

Cornerstone Family Healthcare welcomes all people in need of medical care, regardless of their insurance status or ability to pay. A Sliding Fee Scale Discount Program is offered to all eligible patients. If you and your family do not have health insurance, Cornerstone’s Patient Services team can review your options and help you choose a plan that is right for you.

Cornerstone Family Healthcare accepts most major health insurance plans. Before selecting a Cornerstone provider, please check with your insurance company to verify your eligibility and coverage to ensure the provider participates in your plan. For a list of insurance plans Cornerstone Family Healthcare accepts, please click here:

If you are an uninsured or a self-pay patient, you have the right to request a good faith estimate of expected charges prior to receiving services. 

Patient Services

We’re here to help!

The Patient Services team at Cornerstone Family Healthcare is here to help. Patient Services assure that patients can obtain health care services regardless of their insurance or income status. Cornerstone’s Patient Services team can help patients with:
  • Health Insurance Application and Enrollment Assistance
  • Sliding Fee Discount Program HEAP: Home Energy Assistance Program
  • SNAP: Supplemental Nutrition Assistance Program (Food Stamp)
Please call 845-563-8000 to request Patient Services assistance with any of these programs.​

Health Insurance Application and Enrollment Assistance

Certified Application Counselors are available to assist patients access medical services by providing health insurance application and enrollment assistance via the New York State of Health Marketplace. Insurance options include:

Sliding Fee Discount Program

Cornerstone Family Healthcare provides essential medical services regardless of a patient’s ability to pay. If you are uninsured or have a high-insurance deductible, the Sliding Fee Discount Program assures that all patients (with and without health insurance coverage) have access to medical care services. Eligibility for the Sliding Fee Discount Program is based upon poverty guidelines established by the Federal Government and are determined by family size and income.

To apply for sliding fee services and alternate payment arrangements you will need to provide proof of income for yourself and any individual in your household. We will require any one of the following items:

Insured patients with income at or below 200% of the FPL are eligible for the Sliding Fee Scale discount. Eligibility is based on income and family size in accordance with the most recent Federal Poverty Guidelines. If eligible, Cornerstone will bill the insurance first, then apply the sliding fee discount by charging a fee no greater than what would be charged to a patient who has no public or private insurance in a defined income category.

Patients interested in the Sliding Fee Scale Program should contact 845-563-8000 for more information.

Please allow at least one hour prior to your medical appointment to apply for the Sliding Fee Scale Program.

Patient Services Hours and Contact Information

NEWBURGH​

147 Lake Street
Monday – Thursday: 9 AM – 7 PM
Friday: 9 AM – 5 PM
Saturday: 9 AM – 1 PM

MIDDLETOWN​

10 Benton Avenue
Monday – Friday: 9 AM – 5 PM

PORT JERVIS

140 Hammond Street
Monday – Wednesday: 9 AM – 5 PM

Make a Payment​

Need to make a payment? Click on the link.

Cornerstone Family Healthcare accepts the following insurance plans:

Medical/Behavioral Health Insurances:
  • Aetna HMO
  • Aetna PPO
  • Affinity by Molina Healthcare
  • Amerihealth
  • CDPHP
  • Cigna
  • EMBLEM
  • Empire BCBS
  • Excellus (Binghamton – Only)
  • NYS Empire Plan
  • Fidelis
  • Geisinger
  • GHI HMO
  • GHI PPO
  • HealthFirst
  • HIP
  • Magellan
  • Magna Care
  • Medicaid
  • Medicare
  • Multiplan
  • MVP
  • Optum
  • Oxford (Excludes Metro Plan)
  • Tricare
  • Value Options
  • United Healthcare
  • Wellcare
Dental Specific Plan(s):
  • Careington Dental
  • Connection Dental
  • CSEA
  • Deltacare
  • Delta Dental
  • Dentegra
  • Dentemax
  • Dentaquest
  • Healthplex
  • Liberty Dental
  • Local 707
  • Local No. 17
  • Metlife DHMO
  • Metlife PPO
  • PBA
  • Principal
  • Sunlife Dental (previously known as DNOA)
Audiology Specific Plan(s):
  • Amplifon
Optometry Specific Plan(s):
  • Davis Vision
  • EyeMed
  • Superior Vision
  • March Vision