Forms

Patient Registration Form

English

Patient Consent for Services – English

Spanish

Patient Consent for Services – Spanish

Alexander Valley Healthcare is an FTCA deemed facility. AVH is a Health Center Program grantee under 42 U.S.C. 254b and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.