Documents and Forms
Below are documents and forms for registering for our services. For an Insurance Enrollment appointment or before your first Medical or Dental appointment please fill out the medical or dental registration packet for your patient(s) age range and the Records Release Consent form. These are available in English, Spanish, and Russian.
If you need to request your medical records or dental records fill out the records release consent form. The form can be faxed to the records department at (253) 722-1738 or mailed to Community Health Care, 1148 Broadway Suite 100, Tacoma, WA 98402.
English Forms
Medical Registration Packet--Infant 0-1 (English)
Medical Registration Packet--Child 1-12 (English)
Medical Registration Packet--Adolescent 13-18 (English)
Medical Registration Packet--Adult (English)
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent
Notice of Privacy Practices
Patients Rights and Responsibilities
New Patient Handbook
Russian Forms
Medical Registration Packet--Infant 0-1 (Russian)
Medical Registration Packet--Child 1-12 (Russian)
Medical Registration Packet--Adolescent 13-18 (Russian)
Medical Registration Packet--Adult (Russian)
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent
Notice of Privacy Practices
New Patient Handbook
Spanish Forms
Medical Registration Packet--Infant 0-1 (Spanish)
Medical Registration Packet--Child 1-12 (Spanish)
Medical Registration Packet--Adolescent 13-18 (Spanish)
Medical Registration Packet--Adult (Spanish)
Dental Registration Packet
Sliding Fee Scale Application
Records Release Consent-Spanish-1
Notice of Privacy Practices
New Patient Handbook