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.
Authorization to Release Health Information (MEDICAL), (DENTAL)
Authorization to Receive Health Information (MEDICAL), (DENTAL)
Authorization to Exchange Verbal Information, (En Español)
Adult Health History, (En Español)
Child Health History, (En Español)
Health History Dental, (En Español)
Prescription Refill Policy, (En Español)
Slide Discount Application
Eating For Peak Athletic Performance
Authorization For Dental Hygiene Services
Dental Prevention Slide Application