Forms « East Texas Community Health Services, Inc.

Forms

	English New Patient Information Packet Adobe PDF Format – MS Word Format
	Spanish New Patient Information Packet Adobe PDF Format – MS Word Format
	English Apply for Health Care Assistance Adobe PDF Format – MS Word Format
	Spanish Apply for Health Care Assistance Adobe PDF Format – MS Word Format

Copyright © 2019 East Texas Community Health Services, Inc. - All Rights Reserved

This health center is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n) and an FTCA deemed facility.

This health center receives HHS funding and has Federal Public Health Services (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.