HMC


Health Medicine Center
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Health Medicine Center
1620 Riviera Ave
Walnut Creek, CA 94596


(925) 935-7500

 

 

 

Registration Forms
Download and fill out our patient registration documents in the comfort and convenience of your own home or office. This will expedite the Health Medicine Center registration process.

Registration forms require
Adobe Acrobat Reader.
Get Adobe Reader
It's free! 

Please read the Notice of Privacy Practices before signing the privacy notice agreement. You are welcome to keep a copy of these documents for your records.

Registration forms require
Adobe Acrobat Reader.
Get Adobe Reader
It's free! 

Download Instructions

There are a couple of ways to download and print the registration documents:

1) Click on the desired document icon and the document will open to allow you to view, print and/or save the forms. To save these documents to your computer, select Save from the File menu, or click the 'Save' icon on the toolbar.

2) In some browsers such as IE, you can save the documents directly to your computer when you right-click on the document icon and select 'Save Target As...' from the drop-down menu.

 
Please contact us if you have any questions about filling these forms out.
 
   
   

Health Medicine Center
1620 Riviera Ave
Walnut Creek, CA  94596

Tel: (925) 935-7500
FAX: (925) 935-7770