Fast Track Medical Forms

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Medical Forms

Print and fill out these medical forms and bring them with you to expedite your check-in process.

Form English Spanish Chinese
Patient Registration Download Patient Registration Descargar 下載
Advance Beneficiary Notice (ABN) Download Advance Beneficiary Notice Descargar N/A
Patient Consent Form (HIPAA) Download Patient Consent Form Descargar 下載
HIV Consent Form Download HIV Consent Form N/A N/A
Medical Release Form Download Medical Release Form N/A N/A
Medical History Download Medical History N/A N/A

Paying by Credit Card?
Please fill out this form, bring it with you, email or fax it to us.

Credit Card Authorization Form English N/A N/A

What you’ll need on your visit:

All current insurance cards
One (1) Official picture ID (Driver’s license, passport…)
Co-pay is expected prior to being seen, no personal checks acceptable.
Please arrive on-time

Schedule a Tour

Ambulance Service Provided By: