Downloadable Forms

Filename Size Date & Time
An Adobe Acrobat file CustomerSurvey 207.87 KB 2017-05-08 21:29:54
An Adobe Acrobat file EMP-F04E_Employment_App 374.2 KB 2017-09-25 17:57:29
An Adobe Acrobat file FIN-F15F Sliding Fee Application 102.09 KB 2017-09-25 17:57:29
An Adobe Acrobat file HIPAA_English 87.61 KB 2017-07-05 17:17:47
An Adobe Acrobat file HIPAA_Spanish 93.34 KB 2017-07-05 17:18:20



 

Canby Family Practice Clinic | PO Box 322 | Highway 299 and County Road 83 | Canby, CA 96015
Phone: 530-233-4641 | Insurance/Billing Fax: 530-708-8937 | Medical Fax: 530-233-2830 | Dental Fax: 530-708-8946

HOURS 8 AM-Noon & 1 PM-5 PM Monday-Friday
 We’re on Maps


AN EQUAL OPPORTUNITY EMPLOYER | DOWNLOAD OUR EMPLOYMENT APPLICATION HERE
SE HABLA ESPAÑOL


© Copyright 2017 I'SOT Inc. dba Canby Family Practice Clinic. All rights reserved.
Website by Terry R. Miller
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