Chandler CARE Center
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Chandler CARE Center FormsThe forms below are available for your convenience.
Sports Physicals - EnglishPlease print all forms and complete forms 1-3. Physician Evaluation Form will be completed by physician during your appointment. 1.
Child and Adult Immunization Forms - EnglishClick below to download or print immunization registration forms: https://www.dignityhealth.org/arizona/locations/chandlerregional/about-us/immunization-clinics
Dental Forms - English1.
Patient Information Form Click Here 2.
Patient Dental Health History Click Here All Medical Appointment Forms - English1.
Patient Information Form Click Here 2.
Medical History Form Southwest Behavioral Referral Form - English1.
Southwest Behavioral Form Vision & Hearing Forms - English1.
Vision and Hearing Client Information Form Click Here 2.
Vision and Hearing Client Consent to Treat Form Click Here 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 2. AHCCCS Assistors List - Where to Find Help - Click Here
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Address
Phone
Center Hours
Email
777 E. Galveston St.
Chandler, AZ 85225
480-812-7900
Monday - Thursday
7:30 a.m. - 4:30 p.m.Friday7:30 a.m. - 3:30 p.m.Join us on Facebook!!