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Information About COVID-19

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Menu
  • About Us
  • Services
    • Family Medicine Services
    • Behavioral Health Services
    • Virtual Visits & Telehealth
    • Family Dental Services
    • Family Physical Therapy Services
    • Pharmacy
  • Special Programs
    • Nurse Family Partnership
    • Case Management and Care Coordination
    • Women, Infants and Children (WIC)
    • Community Engagement Programs
    • Reach Out & Read
    • Alamosa Rural Training Track
  • For Patients
    • Coronavirus Updates
    • Patient Forms
    • Patient FAQ’s
    • Patient Rights and Responsibilities
    • Insurance and Financial Assistance Program Information
    • Compliance
    • CIIS Registry
    • Transparency in Health Care Prices Act
    • Patient Education
  • Providers
  • Careers
  • Locations
  • Employee Resources
  • Transportation
  • News
  • Contact Us

School-Based Health Forms

Patient Info Brochure English and Spanish

Forms in English

SBHC Patient Information Form
SBHC Health History Form
SBHC Medical Consent Form for Children Over 12
SBHC Hygiene Services Consent Form
Notice of Privacy Practices

Forms in Spanish

SBHC Patient Information Form - Spanish
SBHC Health History - Spanish
Notice of Privacy Practices 2020 - Spanish

Please submit forms to SBHC@valley-widehealth.org If you need assistance, please contact our front desk staff at 719-204-7410.

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This post is also available in: English

Patient Portal
Pay My Bill
Contact Us
  • About Us
  • Services
    • Family Medicine Services
    • Behavioral Health Services
    • Virtual Visits & Telehealth
    • Family Dental Services
    • Family Physical Therapy Services
    • Pharmacy
  • Special Programs
    • Nurse Family Partnership
    • Case Management and Care Coordination
    • Women, Infants and Children (WIC)
    • Community Engagement Programs
    • Reach Out & Read
    • Alamosa Rural Training Track
  • For Patients
    • Coronavirus Updates
    • Patient Forms
    • Patient FAQ’s
    • Patient Rights and Responsibilities
    • Insurance and Financial Assistance Program Information
    • Compliance
    • CIIS Registry
    • Transparency in Health Care Prices Act
    • Patient Education
  • Providers
  • Careers
  • Locations
  • Employee Resources
  • Transportation
  • News
  • Contact Us
Menu
  • About Us
  • Services
    • Family Medicine Services
    • Behavioral Health Services
    • Virtual Visits & Telehealth
    • Family Dental Services
    • Family Physical Therapy Services
    • Pharmacy
  • Special Programs
    • Nurse Family Partnership
    • Case Management and Care Coordination
    • Women, Infants and Children (WIC)
    • Community Engagement Programs
    • Reach Out & Read
    • Alamosa Rural Training Track
  • For Patients
    • Coronavirus Updates
    • Patient Forms
    • Patient FAQ’s
    • Patient Rights and Responsibilities
    • Insurance and Financial Assistance Program Information
    • Compliance
    • CIIS Registry
    • Transparency in Health Care Prices Act
    • Patient Education
  • Providers
  • Careers
  • Locations
  • Employee Resources
  • Transportation
  • News
  • Contact Us

Main Office: 128 Market Street, Alamosa, CO 81101 | 719-587-1001
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Recognized by the American Heart Association (2020)

Accredited/Certified by
HRSA Health Center Program Operational Site Visit

HRSA Recognition: Advancing HIT for Quality

HRSA Recognition: COVID-19 Data Reporter

AAAHC Accreditation

HRSA Recognition: Patient Centered Medical Home

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