Forms

Sliding Fee Form

Once you have filled out this form please email it to: laurenr@achcid.org

SLIDING FEE APPLICATION 2026

SLIDING FEE APPLICATION Spanish 2026

Patient Forms

Once you have filled out any of the forms please email them to: melissar@achcid.org or reception@achcid.org

ADULT NEW PATIENT PACKET 2026

MINOR NEW PATIENT PACKET 2026

ADULT NEW PATIENT PACKET Spanish 2026

MINOR NEW PATIENT PACKET Spanish 2026

Adams County Health Center HIPAA Patient Privacy