Skip to Main Content
Loading
Loading
Create a Website Account
- Manage notification subscriptions, save form progress and more.
Website Sign In
Search
About Us
Records & Statistics
Programs
Environmental Health
Clinic Services
Home
Clinic Services
Immunizations
Appointment Forms
Appointment Forms
Immunizations
Acknowledgement of Receipt (PDF)
Adult Screening (PDF)
Adult Screening Spanish (PDF)
Child Screening (PDF)
Child Screening Spanish (PDF)
Comprehensive History Form (DOCX)
Comprehensive History Form Spanish (PDF)
HIPAA Patient Acknowledgement Spanish (DOCX)
Immunization Client Registration (DOCX)
Notice of Privacy Practices (PDF)
Notice of Privacy Practices Spanish (PDF)
Patient Finanical Responsibility Agreement (PDF)
Pre-Vaccination Screening Form (PDF)
Pre-Vaccination Screening Form Spanish (PDF)
STI Consent (DOCX)
WWC Client Profile (PDF)
WWC Client Profile Spanish (PDF)
WWC Consent (PDF)
WWC Consent Spanish (PDF)
Sexual Health Clinic
WWC Consent Español (PDF)
WWC Consent English (PDF)
HIPAA Waiver English (PDF)
HIPAA Waiver Español (PDF)
Client Registration Form Español (PDF)
Client Registration Form English (DOCX)
Family Planning Consent English (DOCX)
Family Planning Consent Español (DOCX)
Appointment Forms
COVID-19
Birth & Death Certificates
Food & Safety
Women, Babies, & Children
Clinic Services
Health Insurance Literacy
Government Websites by
CivicPlus®
Arrow Left
Arrow Right
[]
Slideshow Left Arrow
Slideshow Right Arrow