VALLEY INFECTIOUS DISEASE ASSOCIATES

Registration forms

We request that new patients download and fill out forms beforehand to ensure faster service

ID clinic registration forms

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• New patient registration form

• HIPPA Form

• Acknowledgment of Receipt of Notice of Privacy Practices Form

Travel clinic registration forms

• Patient Registration Form

• Patient Registration for Haitian volunteers

• Patient Medical History Form

• Travel Medicine Clinic HIPPA Form

• TB Test and Form

• Acknowledgment of Receipt of Notice of Privacy Practices Form