Pediatric Past Medical History - 1 - 2 Years Pediatric Past Medical History - 7-12 Months Pediatric Past Medical History - 2 - 6 Months Pediatric Past Medical History - 0-2 Months Screening Checklist for Contraindications to Vaccines for Adults Screening Checklist for Contraindications to Vaccines for Children and Teens Please, bring all immunization records to every visit with us.īorrego Health Notice of Privacy Practices ** A copy of the immunization record will also be needed for all adults and children. Screening Checklist for Contraindications to Vaccines for Adults - Arabic Screening Checklist for Contraindications to Vaccines for Children and Teens - Arabic You can download Adobe Acrobat Reader here.īorrego Health Notice of Privacy Practices- Arabic You will need Adobe Acrobat Reader to read and print these forms. Our Customer Service Representative will enter your information into our Electronic Health Record System. Bring the completed forms, a photo ID and your insurance card(s) with you to your appointment. You may download and fill them out at your convenience prior to your first appointment. The forms listed below are provided to allow those who wish to complete their new patient paperwork at home to do so.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |