Patient Forms

Siskiyou Community Health Center has made available several forms to save you time when you visit your doctor.
Just click on the link, print, fill out and bring them to your first visit.

Forms (English)

Forms (En Español)

LINKS

As a community health center, Siskiyou provides personalized, patient-centered care to help manage your individual and family wellness needs through all stages of life. Our goal is to provide a medical home that focuses on high-quality primary and preventive care for the whole family.

GRANTS PASS

1701 NW Hawthorne Ave, Grants Pass, OR 97526 (541) 472-4777 (24 hours, 7 days a week) Fax (541) 471-1439 557B NE Westbrook Way, Grants Pass, OR 97526

CAVE JUNCTION

25647 Redwood Hwy., Cave Junction, OR 97523 (541) 592-4111 (24 hours, 7 days a week) Fax (541) 592-3916

MEDFORD (Healthy Families Program)

1380 Biddle Road, Suite D, Medford, OR 97504

HEALTH SERVICES

© Copyright 2023. Siskiyou Community Health Center. This health center receives Health and Human Services funding and has Federal Public Health Service deemed status concerning certain health or health-related claims, including malpractice claims, for itself and its covered individuals. Siskiyou Community Health Center is an equal opportunity employer and provider.