Patient Forms and Resources

The patient is at the center of all we do. That’s why we provide easier ways to access health services, in a compassionate and comfortable environment. We care about every person who walks through our door, respecting and responding to each health need.

Patient Forms:

• New Patient Intake Packet-English
• New Patient Intake Packet-Spanish 
• Sliding Fee Program Enrollment Forms
  • Sliding Fee Scale Summary
  • Sliding Fee Scale Eligibility
  • Programa De Tarifas Deslizantes
  • Escala de Precios Reducidos

Patient Resources:

• Overview Brochure
• Overview Brochure – Spanish
• Patients Rights and Responsibilities
• Patients Rights and Responsibilities – Spanish
• Good Faith Estimate
• Good Faith Estimate – Spanish
• Notice to Patients
• Notice of Privacy Practices (HIPAA)
• Notice of Privacy Practices (HIPAA) – Spanish