Newcomer Form - Avera Health

Contact Our Newcomer Representative

If you are moving to the Sioux Falls area and would like to talk to our representative please fill out the form below. Our representative will respond to your inquiry within two business days. Please note:

If you have an emergency healthcare need call 911 immediately. If you have an urgent need, contact your family physician, or call ASK-A-NURSE at (605) 322-6877 or (800) 658-3535 (toll-free is available for area codes 605, 507, 320 and 712).
We can't offer medical advice online and are not able to respond to such e-mails. To discuss specific conditions, symptoms or diagnosis contact your physician or an appropriate healthcare professional.

* Required Fields

* First Name

* Last Name

Current Address:

* Address

* City

* State

* Zip

New address in Sioux Falls area (if different from above):

Address

City

State

Zip

* Phone

(xxx-xxx-xxxx)

* Email

* Best Time to Contact

(between 8 a.m. and 7 p.m., Monday through Saturday)

Gender

Date of Birth

(xx/xx/xxxx)

Number of children in household:

Age 5 or Under

Age 6 - 11

Age 12 - 17

Do you have a primary care doctor in Sioux Falls?

Yes

Please check your current health plan:

Other:

Please refer me to a physician who specializes in:

Family Practice

Obstetrics/Gynecology

Pediatrics

Internal Medicine

Other:

I would like more information about:

AveraMcKennan and Avera Health take the issue of privacy very seriously. We do not sell, distribute or transfer personally identifiable information obtained from a user to a third party. Any information collected on this form will only be used for the purpose of the Avera McKennan Newcomer Program.