Are you a new patient of Christ Community? Please print and complete the forms below to bring to your appointment.

Patient Forms:

• New Patient Registration
• Pediatric Health History
• Application for Sliding Fee Financial Assistance
• Application for Sliding Fee Financial Assistance (ES)
• Sliding Fee Scale Information
• Sliding Fee Brochure (ENG)
• Sliding Fee Brochure (ES)
• Consent for Evaluation and Treatment (English)
• Consentimiento para Evaluación y Tratamiento
• Medical Release for Return to Athletic Participation (AUTORIZACIÓN MÉDICA PARA EL REGRESO A LA PARTICIPACIÓN ATLÉTICA)
• Preparticipation Physical Evaluation (Evaluación Física previa a la participación)
• Concussion Return to Play Form (formulario para regresar a jugar después de una conmócion cerebral)

Paying Your Bill Online

Click here to pay your bill.