Forms

Rappahannock Area Health District Client Registration Form: English, Spanish

Informed Consent for Special Health Services and Procedures: English, Spanish

Patient Bill of Rights: English, Spanish

General Health History: English, Spanish

HIPAA Authorization: English, Spanish

Immunization Consent: English, Spanish

TB Risk Assessment(Please only complete the top portion of this form)

Authorization to Use and Exchange Information: English, Spanish

Visit Health History: English, Spanish

Voter Registration Form