New Patients

Acknowledgment of Receipt Notice of Privacy Practices
Acknowledgment of Receipt Notice of Privacy Practices (Spanish)
Medical Release 
Medical Release (Spanish) 
Notice of Privacy Practices
Notice of Privacy Practices (Spanish)
Patient Information - Adults
Patient Information - Adults (Spanish)
Patient Financial Responsibility Form
Patient Financial Responsibility Form (Spanish)

Existing Patients

Medical Release 
Medical Release (Spanish)

New Patients

Acknowledgment of Receipt Notice of Privacy Practices
Acknowledgment of Receipt Notice of Privacy Practices (Spanish)
Authorization Caregiver-Guardian
Authorization Caregiver-Guardian (Spanish)
Medical Release 
Medical Release (Spanish) 
Notice of Privacy Practices
Notice of Privacy Practices (Spanish)
Patient Information - Pediatrics
Patient Information - Pediatrics (Spanish)
Patient Financial Responsibility Form
Patient Financial Responsibility Form (Spanish)

Existing Patients

Medical Release
Medical Release (Spanish)

New Patients

Acknowledgment of Receipt Notice of Privacy Practices
Acknowledgment of Receipt Notice of Privacy Practices (Spanish)
Authorization for Caregiver/Guardian (English and Spanish)
Health History Form - Adult
Health History Form - Adult (Spanish)
Health History Form - Pediatric
Health History Form - Pediatric (Spanish)
Medical Release 
Medical Release (Spanish) 
Notice of Privacy Practices
Notice of Privacy Practices (Spanish)
Patient Information
Patient Information (Spanish)
Patient Financial Responsibility Form
Patient Financial Responsibility Form (Spanish)

New Patients

Notice to Clients
Consumer Information
Consumer Information (Spanish)
Patient Information
Patient Information (Spanish)
Behavioral Health Office Policy and Consent for Treatment
Behavioral Health Office Policy and Consent for Treatment (Spanish)
Patient Financial Responsibility Form
Patient Financial Responsibility Form (Spanish)
Authorization for Behavioral Health and PCP to Share Confidential Information Form
Authorization for Behavioral Health and PCP to Share Confidential Information Form (Spanish)
Acknowledgment of Receipt Notice of Privacy Practices Form
Acknowlegement of Receipt Notice of Privacy Practices Form (Spanish)
Notice of Privacy Practices Form
Notice of Privacy Practices Form (Spanish)

CPCA Patient Handout
Patient Grievance Form
Patient Grievance Form (Spanish)
Sliding Fee 2016
Sliding Fee Discount Schedule
Sliding Fee Discount Schedule (Spanish)
Staff Recognition
Staff Recognition (Spanish)