Forms

In order to schedule your first appointment, all paperwork must have been submitted to the Shingle Springs Health & Wellness Center.  You may FAX your packet to (530) 672-1507 or deliver it to the 5th floor.

Please allow 48 hours for processing.  

Adult Registration Packet

Pediatric Patient Registration Packet

Notice of Privacy Practices

Health Information Management

Release of Health Information to Shingle Springs Health & Wellness Center

Release of Health Information from Shingle Springs Health & Wellness Center

CHS

CHS Registration Form

Contract Health Services Policy A

Contract Health Services Policy B