Due to COVID-19 we are performing a screening upon entry to our building

Bartz-Altadonna Community Health Center

  • Home
  • Services
    • Primary Care
    • Pediatrics
    • Obstetrics and Gynecology
    • Mobile Unit
    • Infectious Disease
    • Orthopedics
    • Behavioral Health
    • Podiatry
    • Pain Management
  • Donate
  • About Us
    • Our Mission
    • Our Story
    • Letter from our Founder
    • Our Donors
    • Governance
    • Management
    • Picture Gallery
    • Hall of Flame
  • Registration Forms
  • Contact Us
  • For Patients
    • How to install MyChart
    • MyChart
    • Using Doxy.me
    • Immunization Records
    • Education
  • More
    • Home
    • Services
      • Primary Care
      • Pediatrics
      • Obstetrics and Gynecology
      • Mobile Unit
      • Infectious Disease
      • Orthopedics
      • Behavioral Health
      • Podiatry
      • Pain Management
    • Donate
    • About Us
      • Our Mission
      • Our Story
      • Letter from our Founder
      • Our Donors
      • Governance
      • Management
      • Picture Gallery
      • Hall of Flame
    • Registration Forms
    • Contact Us
    • For Patients
      • How to install MyChart
      • MyChart
      • Using Doxy.me
      • Immunization Records
      • Education

Bartz-Altadonna Community Health Center

  • Home
  • Services
  • Donate
  • About Us
  • Registration Forms
  • Contact Us
  • For Patients

Registration Forms

New patient registration form (pdf)Download
Sliding fee application (pdf)Download
Forma de registro para nuevo paciente (pdf)Download
Forma de aplicacion para escala de descuento (pdf)Download
Pain Management Contract (pdf)Download
Behavioral Health Sliding Fee 2020 (pdf)Download
Sliding Fee - Primary Care, Podiatry, Ryan White 2020 (pdf)Download
OB/GYN Sliding Fee 2020 (pdf)Download
Pain Management Sliding Fee 2020 (pdf)Download
Psychiatry Sliding Fee 2020 (pdf)Download

Copyright © 2020 Bartz-Altadonna Community Health Center - All Rights Reserved.

  • Home
  • Mobile Unit
  • Donate
  • Privacy Practice
  • Registration Forms
  • Contact Us
  • MyChart
  • Employee Remote Access