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All of our forms can be filled out electronically or printed and filled out by hand.

Before downloading the forms, you need to get the appropriate software - PLEASE READ INSTRUCTIONS BELOW THE LIST OF FORMS.

Forms

Patient Registration Form

Medical Records Form

Sliding Fee Application Form

Dental Medical History Form

Chiropractic Form

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Patient Forms Instructions

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To make an appointment at any location, or to speak with a Financial Services Specialist please call 1-888-730-2374

Para Español

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This institution is an equal opportunity provider and employer.
Palms Medical Group is a FTCA Deemed Facility.
This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).
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