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      • Child Wellness Visits Can Prevent Missed Lead Screenings
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  • Services

    • Medical
      • Child Wellness Visits Can Prevent Missed Lead Screenings
      • Diabetes Care
      • Hypertension & High Blood Pressure
      • Hep C Treatment
      • OB-GYN
      • Pediatric Care
      • Teen Health
    • HIV Care & Prevention
    • Gender Affirming Care
    • Dental
    • Vision
    • Behavioral Health
      • Substance Use and Opioid Use Disorders
    • Laboratory
    • Counseling & Education
    • Gender Affirming Care
    • STD and HIV Testing
    • COVID-19 Vaccine
  • Patients

    • Make an Appointment
      • Adult Medi-Cal Patient
      • Pediatric Medi-Cal Patient
    • Insurance & Eligibility
    • Billing & Finance
    • Letter to our Patients and to the Community
    • Good Faith Estimate
    • Classes and Groups
  • Pharmacy
    • Pharmacy FAQ
    • Automatic Prescription Refill Enrollment
  • Resources

    • News
    • Providers
    • FAQ
    • Partners
    • Patient Forms
    • What is Medi-Cal?
    • Opportunities
    • Media
  • Locations

    • Arden-Arcade Campus
    • Midtown Campus
  • MyChart
  • Careers

    • Recruitment
    • Culture
    • Benefits
    • Sacramento
    • History
  • Donate
  • About

    • History
    • Leadership
    • Mission and Vision
    • Values
    • Legal Notices
  • Contact
Resources

One Community Health is committed to providing the information and tools needed to best manage your health.

Patient Forms

You can download these forms to fill out before you come in for an appointment.

Release Forms
Medical Records or Health Information Form – English
Medical Records or Health Information Form – Spanish
Medical Records or Health Information Form – Dari
Medical Records or Health Information Form – Pashto
Information to Discuss Your Health Information with Others

 

Sliding Fee Forms
Sliding Fee Discount Application – Self Declaration – English
Sliding Fee Discount Application – Self Declaration – Spanish

 

Notice and Service
Non-Discrimination Notice
Language Assistance Services
Patient Notices & Policies – English
Patient Notices & Policies – Spanish
Patient Notices & Policies – Dari
Patient Notices & Policies – Pashto

Since our beginning in 1989, it has been our mission to create a healthier Sacramento by increasing access to care for all members of our community, regardless of age, gender, ethnicity, orientation, or ability to pay. Follow our journey.

Stay connected with the One Community Health e-newsletter:

1500 21st Street
Sacramento, CA 95811

Contact Us
phone icon916 443-3299

Compliance Hotline: 833 969-2549
  • Services
  • Patients
  • Providers
  • Resources
  • Locations
  • MyChart
  • Careers
    • Recruitment
    • Culture
    • Benefits
    • Sacramento
    • History
  • Donate
  • About
    • History
    • Leadership
    • Mission and Vision
    • Values
    • Legal Notices
  • Contact
  • en_USEnglish
    • fa_IRPersian
    • ru_RURussian
    • pa_INPanjabi
    • psPashto
    • arArabic
    • zh_CNChinese
    • zh_HKChinese
    • zh_TWChinese
    • es_MXSpanish
    • es_ESSpanish
    • tlTagalog
    • viVietnamese
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