Siskiyou Community Health Center has made available several forms to save you time when you visit your doctor.
Just click on the link, print, fill out and bring them to your first visit.
Registration Packet – Medical (En Español)
Registration Packet – Dental
Authorization to Release Health Information (MEDICAL), (DENTAL)
Authorization to Receive Health Information (MEDICAL), (En Español), (DENTAL)
Authorization to Exchange Verbal Health Information, (En Español)
Dental Prevention Slide Application
Authorization For Dental Hygiene Services
Slide Discount Application, (En Español)
Eating For Peak Athletic Performance
School-Based Health Center Registration
Kids Smile Dental Prevention Program Registration
OHP Consent Packet, (En Español)