For your convenience, please print a copy of the appropriate paitent form, complete it and bring it with you to your appointment. In addition, if you are a female patient coming in for your first exam visit, please print the Female Health History form and complete that, too. A staff member will review these forms with you at the time of your visit, so if any questions are unclear to you, just leave them blank.

Patient Registration Form - Please bring this with you each time you have a scheduled appointment.

Female History Form - If you are a female patient visiting one of our health centers for the first time, please print, complete and bring this form with you to your appointment. 

Male History Form - If you are a male patient visiting one of our health centers for the first time, please print, complete and bring this form with you to your appointment.

Female Annual Visit Form - If you are a female patient coming in for your annual exam please print, complete and bring this form with you to your appointment.

SelectPlan for Women Application - To find out more about SelectPlan click here. Please bring the completed form and a recent pay stub for proof of income to your medical office visit.

Solicitud para el plan SelectPlan for Women - Traiga por favor llenada el formulario y un reciente talonario para la prueba de la renta a su visita médica de la oficina.