Form Downloads for

Xcel Urgent Care

Patient Registration Form (pdf)

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HIPAA Compliance Consent Form (pdf)

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Patient Financial Responsibility (pdf)

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Notice of HIPAA Privacy Practices (pdf)

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Credit Card Authorization (pdf)

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Immigration Exam Intake (pdf)

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Medical Records Release TO Xcel, Bilingual (pdf)

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Medical Records Release FROM Xcel, Bilingual (pdf)

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