Practice Forms

Our goal is to always provide you with the best possible patient experience. To help you, we have provided registration paperwork below that you can fill out prior to your visit. Once you have completed these forms, please print and bring them with you to your appointment. 

Patient Resources

Once you have completed these forms, please print and bring them with you to your appointment. If you have any questions regarding the paperwork, please feel free to contact the location you intend to visit and the staff there will assist you in any way possible.

To get started, please choose the office you plan to visit from the drop-down menu.
ImageTitleLanguageDocument Linkhf:tax:facility
CHP Private Practices
CHP Private PracticesEnglish

community-diabetes-endocrine-specialists community-gynecologic-oncology-specialists community-maternal-fetal-medicine-ladella community-medical-oncology-specialists community-neurosciences-institute-%c2%b7-clovis community-neurosciences-institute-%c2%b7-fresno community-neurosciences-institute-%c2%b7-river-park community-neurosciences-institute-%c2%b7-visalia community-pediatric-care community-pediatric-specialists community-perinatology community-primary-care community-primary-care-dr-fayed community-primary-care-milburn community-primary-care-dr-kuebrich-arreola community-primary-care-%c2%b7-alluvial community-primary-care-%c2%b7-halifax community-primary-care-sussex-way community-rheumatology-specialists community-specialty-surgery-associates community-urology-specialists copeland-medical-healthcare-partners-a-member-of-community-health-partners m2-oncology sierra-endocrine-associates
CHP Privacy Practices
CHP Privacy PracticesSpanish

community-diabetes-endocrine-specialists community-gynecologic-oncology-specialists community-maternal-fetal-medicine-ladella community-medical-oncology-specialists community-neurosciences-institute-%c2%b7-clovis community-neurosciences-institute-%c2%b7-fresno community-neurosciences-institute-%c2%b7-river-park community-neurosciences-institute-%c2%b7-visalia community-pediatric-care community-pediatric-specialists community-perinatology community-primary-care community-primary-care-dr-fayed community-primary-care-milburn community-primary-care-dr-kuebrich-arreola community-primary-care-%c2%b7-alluvial community-primary-care-%c2%b7-halifax community-primary-care-sussex-way community-rheumatology-specialists community-specialty-surgery-associates community-urology-specialists copeland-medical-healthcare-partners-a-member-of-community-health-partners m2-oncology sierra-endocrine-associates
Health History & Consent for Treatment
Health History & Consent for TreatmentSpanish

community-pediatric-specialists
Health History & Consent for Treatment
Health History & Consent for TreatmentEnglish

community-pediatric-specialists
New Patient Packet
New Patient PacketSpanish

community-pediatric-specialists
New Patient Packet
New Patient PacketEnglish

community-pediatric-specialists
New Patient Packet
New Patient PacketEnglish

m2-oncology
New Patient Packet
New Patient PacketSpanish

m2-oncology
New Patient Packet
New Patient PacketEnglish

community-medical-oncology-specialists
New Patient Packet
New Patient PacketSpanish

community-medical-oncology-specialists
New Patient Packet
New Patient PacketEnglish

community-gynecologic-oncology-specialists
New Patient Packet
New Patient PacketSpanish

community-gynecologic-oncology-specialists
New Patient Packet
New Patient PacketEnglish

community-perinatology
New Patient Packet
New Patient PacketSpanish

community-perinatology
New Patient Packet
New Patient PacketEnglish

community-specialty-surgery-associates
New Patient Packet
New Patient PacketSpanish

community-specialty-surgery-associates
New Patient Packet
New Patient PacketSpanish

community-primary-care-dr-fayed community-primary-care-dr-kuebrich-arreola
New Patient Packet
New Patient PacketEnglish

community-primary-care-dr-fayed community-primary-care-dr-kuebrich-arreola
New Patient Packet
New Patient PacketEnglish

community-maternal-fetal-medicine-ladella
New Patient Packet
New Patient PacketSpanish

community-maternal-fetal-medicine-ladella
New Patient Packet
New Patient PacketEnglish

community-neurosciences-institute-%c2%b7-clovis
New Patient Packet
New Patient PacketEnglish

community-neurosciences-institute-%c2%b7-fresno
New Patient Packet
New Patient PacketEnglish

community-neurosciences-institute-%c2%b7-river-park
New Patient Packet
New Patient PacketSpanish

community-neurosciences-institute-%c2%b7-clovis
New Patient Packet
New Patient PacketSpanish

community-neurosciences-institute-%c2%b7-fresno
New Patient Packet
New Patient PacketSpanish

community-neurosciences-institute-%c2%b7-river-park
New Patient Packet
New Patient PacketEnglish

community-primary-care-sussex-way
New Patient Packet
New Patient PacketSpanish

community-primary-care-sussex-way
New Patient Packet
New Patient PacketEnglish

community-primary-care-%c2%b7-halifax
New Patient Packet
New Patient PacketSpanish

community-primary-care-%c2%b7-halifax
New Patient Packet
New Patient PacketEnglish

copeland-medical-healthcare-partners-a-member-of-community-health-partners
New Patient Packet
New Patient PacketSpanish

copeland-medical-healthcare-partners-a-member-of-community-health-partners
New Patient Packet
New Patient PacketEnglish

community-primary-care-%c2%b7-alluvial
New Patient Packet
New Patient PacketSpanish

community-primary-care-%c2%b7-alluvial
New Patient Packet
New Patient PacketEnglish

community-diabetes-endocrine-specialists
New Patient Packet
New Patient PacketSpanish

community-diabetes-endocrine-specialists
Fax Referral
Fax ReferralEnglish

community-diabetes-endocrine-specialists
New Patient Packet
New Patient PacketSpanish

community-primary-care
New Patient Packet
New Patient PacketEnglish

community-primary-care
New Patient Packet
New Patient PacketEnglish

sierra-endocrine-associates
New Patient Packet
New Patient PacketSpanish

sierra-endocrine-associates
New Patient Packet
New Patient PacketEnglish

community-urology-specialists
New Patient Packet
New Patient PacketSpanish

community-urology-specialists
CNI Fresno Referral Form
CNI Fresno Referral FormEnglish

community-neurosciences-institute-%c2%b7-fresno
New Patient Packet
New Patient PacketEnglish

community-neurosciences-institute-%c2%b7-visalia
New Patient Packet
New Patient PacketSpanish

community-neurosciences-institute-%c2%b7-visalia
CNI Visalia Referral Form
CNI Visalia Referral FormEnglish

community-neurosciences-institute-%c2%b7-visalia
New Patient Packet
New Patient PacketEnglish

community-primary-care-milburn
New Patient Packet
New Patient PacketSpanish

community-primary-care-milburn
New Patient Packet
New Patient PacketEnglish

community-rheumatology-specialists
New Patient Packet
New Patient PacketSpanish

community-rheumatology-specialists
Fax Referral
Fax ReferralEnglish

community-rheumatology-specialists
New Patient Packet
New Patient PacketEnglish

community-pediatric-care
New Patient Packet
New Patient PacketSpanish

community-pediatric-care
Pediatric Health History Questionnaire
Pediatric Health History QuestionnaireEnglish

community-pediatric-care

Please do not email these forms to your provider or the location you intend to visit. Email communication is not secure and your protected health information (PHI) may be intercepted or compromised by people other than the intended recipient.

Things to bring with you to your appointment: 

  • Completed forms 
  • Insurance cards 
  • Photo identification
  • Co-pay
  • List of medications 
  • Any other medical records or information that we may have requested    

Thank you for trusting Community Health Partners with your care!  

COVID-19 Information

The coronavirus pandemic — also known as COVID-19 — has been declared an international  public health emergency by the World Health Organization and cases continue in California, around the United States and globally. Your health and safety is our top priority, which means your next visit may look different than what you’re used to.