Bartz-Altadonna Community Health Center
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    • Home
    • Education
    • 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
    • Registration Forms
    • Contact Us
    • For Patients
      • MyChart
      • Immunization Records
Bartz-Altadonna Community Health Center
  • Home
  • Education
  • Services
  • Donate
  • About Us
  • Registration Forms
  • Contact Us
  • For Patients

Registration Forms

Adult Registration Packet (pdf)
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Minors Registration (pdf)
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Sliding Fee Application - Primary Care (pdf)
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Sliding Fee Application - Psychiatry (PDF)
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Sliding Fee Application - Pain Management (PDF)
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Sliding Fee Application - Mental Health (PDF)
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Paquete de registro para Adultos (pdf)
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Paquete de registro para Menores (pdf)
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Aplicacion para escala de descuento - Cuidados Primarios (pdf)
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Aplicacion para escala de descuento - Psyquiatria (pdf)
Download
Aplicacion para escala de descuento - Manejo del Dolor (PDF)
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Aplicacion para escala de descuent - Salud Mental (PDF)
Download

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