• DHHS 2734: Referral / Follow Up (PDF, 22 KB)
• DHHS 2800: Personal Data Sheet (PDF, 46 KB)
• DHHS 2801: Problem Need List (PDF, 40 KB)
• DHHS 2802: Medication Flow Sheet (PDF, 27 KB)
• DHHS 2803: Notes (PDF, 22 KB)
• DHHS 2804: Flow Sheet (PDF, 27 KB)
• DHHS 2808: Sexually Transmitted Diseases (PDF, 123 KB)
• DHHS 2809: Children's Special Health Flow Sheet (PDF, 41 KB)
• DHHS 2811: Child Basic History - Birth to 11 Years (PDF, 39 KB)
• DHHS 2812: Child Health Flow Sheet (PDF, 46 KB)
• DHHS 2813: Dietary Recall Food Frequency Flow Sheet (PDF, 39 KB)
• DHHS 2814: Family Planning and Reproductive Health Female Flow Sheet (PDF, 46 KB)
• DHHS 2814: Family Planning and Reproductive Health Male Flow Sheet (PDF, 50 KB)
• DHHS 2814: Instructions (PDF, 18 KB)
• DHHS 2816: Adolescent Basic History (PDF, 35 KB)
• DHHS 2817: Immunization Skin Test Flow Sheet (PDF, 44 KB)
• DHHS 3096: Acknowledgement of Receipt of Notice of Privacy Practices (English-Spanish) (PDF, 23 KB)
• DHHS 3993: Patient Education (PDF, 29 KB)
• DHHS 4056: Patient Authorization (English-Spanish) (PDF, 20 KB)
• DHHS 4059: Patient Visit Record (PDF, 18 KB) - Updated 11/19/09
• DHHS 4060-E: Patient Self History (English) (PDF, 26 KB)
• DHHS 4060-S: Patient Self History (Spanish) (PDF, 34 KB)