Documents and Forms
Below are documents and forms for registering for our services. For an Insurance Enrollment appointment or before your first Medical or Dental appointment please fill out the medical or dental registration packet for your patient(s) age range and the Records Release Consent form. These are available in English, Spanish, and Russian.
If you need to request your medical records or dental records fill out the records release consent form.
For more information, go here: Medical Records | Community Health Care
English Forms
Patient Information New Minor
Patient Information Annual Minor
Child Health History Ages 1-12 Yrs
Adolescent Health History Ages 13-18 Yrs
Patient Information New Adult
Patient Information Annual Adult
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent
Notice of Privacy Practices
Patients Rights and Responsibilities
New Patient Handbook - 2025
Current Good Faith Estimate Guide
Patient Portal English and Spanish
Russian Forms
Patient Information New Minor R
Patient Information Annual Minor R
Child Health History Ages 1-12 Yrs
Adolescent Health History Ages 13-18 Yrs
Patient Information New Adult R
Patient Information Annual Adult R
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent
Notice of Privacy Practices
New Patient Handbook - 2025_Russian_01302025
Current Good Faith Estimate Guide_Russian
Spanish Forms
Patient Information New Minor S
Patient Information Annual Minor S
Child Health History Ages 1-12 Yrs
Adolescent Health History Ages 13-18 Yrs
Patient Information New Adult S
Patient Information Annual Adult S
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent-Spanish-1
Notice of Privacy Practices
New Patient Handbook - 2025_Spanish_01302025
Current Good Faith Estimate Guide_Spanish
Patient Portal English and Spanish
Vietnamese Forms
Patient Information New Minor V
Patient Information Annual Minor V
Child Health History Ages 1-12 Yrs
Adolescent Health History Ages 13-18 Yrs
Patient Information New Adult V
Patient Information Annual Adult V
Dental Registration Packet
Sliding Fee Scale Application
Current Good Faith Estimate Guide_Vietnamese
New Patient Handbook - 2025_Vietnamese_01302025