Treasure Coast Community Health
Accessibility Disclaimer: Please contact our office should you require any assistance with these forms. These forms are in PDF format that can be downloaded then zoomed for persons with visual impairments.
Click on a link below to download a printable copy
Download New Patient Registration (English)
Download New Dental Patient Form (English)Download Health Navigator Form (English)
Download Consent for Treatment Form (English)
Download Adult Behavioral Health Patient Packet (English)
Download Child / Adolescent Behavioral Health Patient Packet (English)
Download Medical Request Form (English)
Download Authorization for Release of Behavioral Health Information Form (English)
Download Patient Bill of Rights and Responsibility Form
Download Notice of Privacy Practice Form (English)
Download Adult Behavioral Health Cancelation Procedures (English)
Descargar Formulario de Registro de Paciente (Espanol)
Descargar Registro Dental de Pacientes (Espanol)Descargar Salud Navigator (Espanol)
Descargar Tratemiento/Autorizcion De Pago Form (Espanol)
Descargar Contrato del Pacientes para Servicios de Salud Mental (Espanol)
Descargar Contrato de los Pacientes Pediatricos para Servicios de Salud Mental (Espanol)
Download Medical Request Form (English)
Descargar Declaracion de Derchos Y Responsabilidades Del Paciente Form (Espanol)
Descargar Aviso de Practicas De Privacidad (Espanol)