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
Patient Handbook - includes your Patient Bill of Rights & Responsibilities and Privacy Practices
Other Important Information
MyChaseBrexton.org - Your Patient Portal! Communicate with your Chase Brexton provider, make a fast, secure bill payment, request a prescription refill, view your lab results, and much more.
Verification of No Income: English // Spanish
Sliding Fee Scale FAQ: English // Spanish
Allow Chase Brexton to Discuss Your Care: English // Spanish
Request Records from an Outside Provider: English // Spanish
Request Records from Chase Brexton: English // Spanish
Designation for Another Person to Consent for Medical Care Form: English // Spanish
Your Health History - A Short Record for Your Own Knowledge