Patient Forms & Applications
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Patient Forms & Applications
- Financial Screening Form (Spanish)
- Financial Screening Form (Chinese)
- Financial Screening Form (English)
- HIPAA Release Form (Chinese)
- HIPAA Release Form (Spanish)
- HIPAA Release Form (English)
- Patient Registration Form (Spanish)
- Patient Registration Form (Chinese)
- Patient Registration Form (English)
Health Center Policies
- Patient's Bill of Rights
- Patient's Responsibilities
- Notice of Privacy Practices
- Aviso de prácticas de privacidad
- Sliding Scale Payment Plan
- Patient Grievance Policy Notice
- Aviso Sobre La Politica De Reclamaciones De APICHA
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Consumer Protection and Credit Card Notification (English, Spanish and Chinese)
Health Education Resources
- Asian Hate Crime Resource Guide
- COVID-19 Guide & Information
- Primary Care Guide
- Transgender Health Care Guide
- Sexually Transmitted Infections (STIs) & Sexually Transmitted Diseases (STD's)
- PrEP (Pre-Exposure Prophylaxis)
- Women's Health
Apicha Newsletters