Forms

All important patient forms and files can be viewed and downloaded below. 

How to Use Fillable Forms

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Screening Schedule for 2025

• Screening Schedule

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Patient Forms

Dental

Dental Forms

Medical

New Medical Patient Application

For Parent/Guardians

• Permission to Accompany/Treat Minor

School Based Health Centers (Students)

• SBHC Enrollment (Online Form)
• SBHC Consent (Online Form)

Privacy Practices

• Notice of Privacy Practices for Health Information Exchange (HIE)
• Notice of Privacy Practices

Patient Discount Program

• Patient Discount Application
• Patient Discount Income Chart

Community Health Needs Assessment

• 2024 Community Health Needs Assessment

Other

• Patient Rights and Responsibilities
• Community Resource Guide