Become a HealthAccessRI Patient at:
Family Doctors of East Providence, Inc.
Stop: Have you completed Step 1 (Pateint Contract)?
If not, click here to return.
If so, please proceed.
Step 2: Enrollment
When you have read all of the information on this page carefully, complete and submit the enrollment form below. We will contact you after we receive it to confirm your enrollment and billing preferances.
| Plan Name | Annual Enrollment Fee | Fee for each office visit |
| 299-0 | $299 | $0 |
| 149-25 | $149 | $25 |
| 99-40 | $99 | $40 |
Multiple Family Member Discount (applies to individuals residing at the same address, who are related to the Primary Family Member by blood, marriage or guardianship. Discount is off total family fees and excludes $15 per person application fee).
2nd family member: 4%
3rd family member: 6%
4th family member: 8%
5th and additional family members: 10%
Form Instructions: The form below is just the begining of your enrollment, telling us how many family members are enrolling and which fee plan each is choosing. We will contact you after we receive it to confirm your enrollment and billing preferances.