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Patient Forms

Patient Registration
English PDFSpanish PDF
Advance Directive
English PDFSpanish PDF
Medicare Annual Wellness Visit Health Risk Assessment
English PDFSpanish PDF
Medical Records Request
English PDFSpanish PDF
Sliding Fee Discount Application
English PDFSpanish PDF
Patient Complaint Form
Open Form
Need help with forms? Contact the Health Information Department at (209) 546-3870, or submit medical records requests by fax to (209) 762-6808 or email prforms@cmcenters.org.