Greater Baden Medical Services Forms
Please print and complete the following information. Bring these forms to your first appointment.

Registration Form

Sliding Fee Scale Form

In Kind Statement

HIPPA Brochure (Privacy)

Acknowledgement of HIPPA Privacy Brochure

Migrant Eligibility Form (Please fill this out if you are a seasonal worker)

Adult History Female (Please fill this out if you are a female adult)

Adult History Male (Please fill this out if  you are an adult male)

For Referring Professionals:

Ryan White Client Intake Forms 

Ryan White Dental Intake (PDF)