Forms

On this page you can access the forms you will need for your appointments with your PTHC clinic. Simply select the appropriate region in the menu at left and download the forms to your computer. You can then fill out the highlighted fields on your computer before printing, or if you prefer, you can fill the forms out by hand later.

It is necessary to have the free Adobe Reader application installed to view these forms. If you do not have it installed, you can download it via the link below.

Get Adobe Reader

Arizona Forms

Patient Information Sheet

PDF

Medical History Form

PDF

Finance Policies

PDF

Patient Information Practices

PDF

Spanish Language

Información del Paciente

PDF

Historia del Paciente

PDF

Finanzas Políticas

PDF

Uso de la Información

PDF

California Forms

Patient Information Sheet

PDF

Medical History Form

PDF

Finance Policies

PDF

Patient Information Practices

PDF

Spanish Language

Información del Paciente

PDF

Historia del Paciente

PDF

Finanzas Políticas

PDF

Uso de la Información

PDF