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Medical Clinic Forms

You are welcome to complete the paperwork at the Clinic Site, or you may print out and complete prior to visiting. We do not charge parents any fees for medical services. We will bill insurance if you have it, however, we will not collect any co-pays, deductibles, or co-insurance. 

AHEC Clinic Consent-EnglishDownload PDF
AHEC Clinic Consent-SpanishDownload PDF
View Medical Consent Form -Haitian CreoleDownload PDF

  • Pay Dental Service Fee
  • School Clinics
  • Tobacco Cessation
  • Professional Education
  • Community Health Programs
  • Make A Difference
  • Home
  • Contact Us
  • Open Facebook in a new tab
  • Open Instagram in a new tab
  • Open LinkedIn in a new tab
  • Open TikTok in a new tab
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