Patient Forms | EVCHC Website
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Patient Forms
New Patient Forms to Download

In-Take Registration Form

Health History Form

Mental Health 

Health Assessment

Informed Consent

Family Income Certification

Good Faith Estimate

Privacy Consent Form

Rights + Responsibility

Behavioral Health Forms to Download

Consent to Treat Minor

Limits of Confidentiality

No Show Policy

Complaints Appeal Form

Advncd Hlth Care Directive

BH Screening Tool

Consent to Release

Dental + Vision Forms to Download

Dental Consent Form

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