Chandler CARE Center / Forms

Chandler CARE Center Forms

The forms below are available for your convenience.

Sports Physicals - English

1.
2018 - 2019 AIA Sports Physical Form

2. Mild Traumatic Brain Injury/Concussion Form

Adult ONLY Immunization Forms - English

1.

Immunization form coming soon.

2.

Updated flu consent coming soon.

Child Immunization Forms - English

1.
Immunization form coming soon.

2.
Updated flu consent coming soon.

Chiropractic Forms - English

1.
Intake Form

2.
Chiropractic Form

3.
Parent/Legal Guardian Consent for Treatment of a Minor

Dental Forms - English

1.
Intake Form

2.
Medical History Form

3.
Parent/Legal Guardian Consent for Treatment of a Minor

TB Skin Test Forms - English

1.
Updated form coming soon.

2.
Updated form coming soon.

3.
Updated form coming soon.

All Medical Appointment Forms - English

1.
Intake Form

2.
Medical History Form

Southwest Behavioral Referral Form - English

1.
Southwest Behavioral Form

Vision & Hearing Forms - English

1.
Vision and Hearing Visit (Minor) Form

Documents Need to Apply for AHCCCS - English

The document below will assist you in determing what items you will need to bring in with you.

1. AHCCCS Checklist


Address	Phone	Center Hours	Email
777 E. Galveston St. Chandler, AZ 85225 Map View	480-812-7900	Monday - Thursday 7:30 a.m. - 4:30 p.m. Friday 7:30 a.m. - 3:30 p.m.	chandlercarecenter@cusd80.com
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Sports Physicals - English

1.	2018 - 2019 AIA Sports Physical Form
2. Mild Traumatic Brain Injury/Concussion Form

Adult ONLY Immunization Forms - English

1.	Immunization form coming soon.
2.	Updated flu consent coming soon.

Child Immunization Forms - English

1.	Immunization form coming soon.
2.	Updated flu consent coming soon.

Chiropractic Forms - English

1.	Intake Form
2.	Chiropractic Form
3.	Parent/Legal Guardian Consent for Treatment of a Minor

Dental Forms - English

1.	Intake Form
2.	Medical History Form
3.	Parent/Legal Guardian Consent for Treatment of a Minor

All Medical Appointment Forms - English

1.	Intake Form
2.	Medical History Form

Southwest Behavioral Referral Form - English

1.	Southwest Behavioral Form

Vision & Hearing Forms - English

1.	Vision and Hearing Visit (Minor) Form

Chandler CARE Center