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  • 127 Telfair Street, Augusta, GA & 1226 D'Antignac Street, Augusta, GA
Christ Community Health Christ Community Health

Affordable, quality primary health and dental care to the uninsured and underserved.

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Christ Community Health > Forms and Policies

Forms and Policies

Forms

Adult Health

Adult Patient Registration Packet – English

Adult Patient Registration Packet – Spanish

 

Pediatrics

Pediatric Patient Registration Packet – English

Pediatric Patient Registration Packet – Spanish

Pediatric Proxy

Pediatric Proxy – Spanish

Pediatric Intake Form (Over 6 months)

Infant Intake Form (Under 6 months)

 

Dental

General Dental Consent Form

General Dental Consent Form – Spanish

 

Advance Directives

Georgia Advance Directive

South Carolina Advance Directive

 

Brochures

Dental

Health

Pediatrics

 

Policies

Patient Manual

Notice of Privacy Practices – English

Notice of Privacy Practices – Spanish

Christ Community Health Provider-Patient Partnership

Patient Centered Medical Home (PCMH) Patient Letter

        

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