Patient Forms & Documents

Patient Forms

Patient Registration & Consent Forms
If you are a new patient or need to update your information, please complete the Patient Registration and Consent to Treat forms below before your appointment.

Patient Registration Form Consent to Treat Form

Patient Registration Form - Spanish Consent to Treat Form - Spanish

School Based Health Services Registration

Register your child for Charles Drew Health Center’s School-Based Health Services by completing the enrollment forms below. Please fill out all required forms before your child’s first appointment.

SBHS Sign-Up Forms

SBHS Sign-Up Forms - Spanish

Prefer to print and bring your forms with you to your appointment? Download, complete, and print these PDFs:

• Patient Registration Form (PDF)
• Consent to Treat Form (PDF)
• Patient Health Questionnaire (PDF)
• Influenza Vaccine Consent Form (PDF)
• COVID-19 Vaccine Consent Form (PDF) 
• SBHS Sign-Up Forms (PDF)
• SBHS Sign-Up Forms – Spanish (PDF)

Not sure which one you need?

Give us a call and we’ll walk you through filling out the right forms for your situation.