Patient Bill of Rights Payment Options MyChart Patient Portal Forms Download forms by clicking the links below.Patient RegistrationSliding Fee Scale ApplicationEnglish Patient Registration FormSpanish Patient Registration FormEnglish Sliding Fee Scale ApplicationSpanish Sliding Fee Scale ApplicationConsent to Treat FormCOVID-19 Vaccine Consent FormsEnglish Consent to Treat FormSpanish Consent to Treat FormCOVID19 Vaccine English ConsentCOVID19 Vaccine Spanish ConsentConsent to Release InformationEnglish Consent to Treat FormOnline Consent to Release Information SubmissionCBCSD Student Consent FormsSports Physical PacketsEnglish Student Consent FormsSpanish Student Consent FormsEnglish Sports Physical PacketsSpanish Sports Physical PacketsFor questions call 712-325-1990.
