General Information
Know Your Numbers
October 26, 27 & 28 (6:30am -8:30am)
Forms to bring:
Know Your Numbers Consent Form
Flu Shots
Forms to bring:
Flu Vaccination Consent Form
Sports Physicals
Forms to bring:
Sports Physical Consent Forms
Suicide Prevention
National Suicide Prevention Lifeline 1-800-273-8255.
Helpful websites:
13 Minutes
Suicide Prevention Lifeline
The Kim Foundation
Healthcare Rights
Advanced Directives
Patient Bill of Rights
Privacy Policy
Nondiscrimination Policy
Patient Forms
Release of Health Information Form
Patient Service Agreement Clinic – Outpatients
Patient Service Agreement Clinic – Outpatients – Spanish
Patient Service Agreement
Patient Service Agreement – Spanish
Resources
2021 Community Needs Assessment
2020 Community Needs Assessment
2017 Community Needs Assessment
2015 Community Needs Assessment
2012 Community Needs Assessment
Patient/Visitor Grievance Form
Health Insurance Marketplace Authorization Form
Functional Needs Registry Information
Dispose of unused, unwanted, or expired medications
www.aseracare.com