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Student Health Services
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Health Services Forms
Student Health Services
Health Services Home
Birth Control and Related Services
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Low-Cost Health Care in Santa Clara County
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Need a Form for Health Services?
Required For ALL Appointments:
Consent to Treat Form
Consent for Telemedicine
No Show Fee
Consent Forms (Consent to Treat, Telemedicine, and No Show Policy)
Patient Registration Form
Service Related Forms:
General Health History Questionnaire
Well Woman Exam Questionnaire
Medical Records Release Form
Part I: TB Risk Assessment and Testing Form
Part II: TB Screening Questionnaire Form
Parental Consent For Minors
Caregiver's Authorization Affidavit
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