Forms

Forms: English

Patient Registration Information

Patient Consent Form

Consent of Medical Treatment for Minors

Adult Past Medical History

Patient Portal Consent

Cell Phone Policy

Forms: Español

Informacion de Registro de Paciente

Consentimiento para el Tratamiento Medico

El Portal de Paciente

Consentimiento para Tratamiento Medico de Menores de Edad

Uso de Teléfonos Celulares y Dispositivos Móviles

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For more information on making an appointment or becoming a new patient, please click here.

• Testimonials

  "Youens & Duchicela Clinic has helped me for about the past 11 years and I wouldn't go anywhere else. The staff is always so sweet and nice and willing to help with whatever I may need."
  
  - Shelby