Documents and Privacy Practices

Before your first appointment, you will need fill out the New Patient Packet for the service you are receiving. If you have access to a printer, please print and bring these forms to your first appointment.

New Patient Packets

Adult Medical,  Case Management, OB/GYN 

Behavioral Health

Dental

Pediatrics

Other Important Information

MyChaseBrexton.org - Your Patient Portal

Patient Portal HelpJust getting started at Chase Brexton? Click here to view an easy, helpful video on how to use our patient portal, MyChaseBrexton.org, to manage your health care! Your health care is just a click away!

Notice of Privacy Practices

Patient Bill of Rights

Fee Scale Application:  English // Spanish

Fee Scale FAQ: English // Spanish

Release of Information Form:   English  //  Spanish

Third Party Designation Form: English // Spanish

Your Health History - A Short Record for Your Own Knowledge

 

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