The following forms can be downloaded and printed. Please fill out the forms and bring in all required documents to the clinic to establish a new chart. If you have any questions, please call 505-908-2307.
Do Not Email forms back to clinic, they will not be accepted.
New Patient Forms
CBNHC New Patient Registration Packet 2022
NoticePrivacyPracticePamphlet-2014
Sports Physical Forms
Parent - Legal Guardian Authorization Form
*Note: This form must be signed at the Clinic in front of Patient Registration staff. A valid State issued ID is required at the time of signature.
Authorization to Appoint a Personal Representative Form
*Note: This form must be signed at the Clinic in front of Patient Registration staff. A valid State issued ID is required at the time of signature.