Downloadable Forms:

• New Patient Information Form - English
• New Patient Information Form - Spanish
• ROI (Authorization to Release Protected Health Information) Third Party Authorization Release- English
• ROI (Authorization to Release Protected Health Information) Third Party Authorization Release- Spanish
• HIPAA Privacy PHI Disclosure Form - English
• HIPAA Privacy PHI Disclosure Form - Spanish
• Notice of Privacy Practices Pamphlet
• Consent to Treat (Adult&Minor) English
• Consent to Treat (Adult&Minor) Spanish
• New Patient Medical History Form (Minor)
• Dental Health History Form
• Patient-Centered Medical Home (PCMH)
• Statement of Income- English
• Statement of Income- Spanish 
• Patient Portal Handout
• Advanced Directives Documents
• Sliding Fee Household Verification - Online Form - English or Spanish
• Sliding Fee Household Verification English - Printable Form
• Sliding Fee Household Verification Spanish - Printable Form
• SHARE Patient Flyer - English
• SHARE Patient Flyer - Spanish
• SHARE Opt-Out Form - English
• SHARE Opt-Out Form - Spanish
• Patient Rights and Responsibilities 
• Vaccine Information Statement
• Sports Physical Form

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