Forms

Printable Enrollment and Consent Forms

Do it online! Click here to easily enroll or consent using our online forms.

Printable versions of enrollment and consent forms are available below.

Enrollment Forms

Comprehensive (Medical, Behavioral, Dental) Enrollment (English)
Comprehensive (Medical, Behavioral, Dental) Enrollment (Spanish)
Behavioral Health Enrollment (English)
Behavioral Health Enrollment (Spanish)
Dental Enrollment (English)
Dental Enrollment (Spanish)
Behavioral Health and Dental Enrollment (English)
Behavioral Health and Dental Enrollment (Spanish)
Short Enrollment Form (Use this form if your child is already a patient at a Community Health Center location and you want to enroll in school-based services)
Short Enrollment Form (Spanish)

Flu Consent Forms

Flu Consent (English)
Flu Consent (Spanish)

 

 

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