Patient Forms
Complete Forms Online
Welcome to the Patient Forms page for Prime Wellness Community Health Center. To save time and improve your experience, we now offer secure online forms you can fill out and submit directly through our website. These forms are mobile-friendly, HIPAA-compliant, and available in multiple languages.
To translate our website and forms into your preferred language, please use Google Translate website.
If you need assistance, please contact us at (310) 659-7867 or info@primewellnesschc.org
| New Patient Initial Appointment Registration Package - For adults (>18 year-old) |
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| Patient Registration |
| Staying Healthy Assessment (SHA) |
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| Staying Healthy Assessment: 0-6 Months |
| Staying Healthy Assessment: 7-12 Months |