›››› Online Registration for New Patients

Registration

If you are a new patient, or if this is your first visit to us since June 1, 2012, please fill out our electronic registration forms. Please arrive 30 minutes early if you are a new patient, or are registering electronically for the first time.

Please

1. Download these forms to your desktop.

2. Print them.

3. Fill them out.

4. Keep them flat.

5. Bring them to your appointment.

For each age category there are 4 forms. (All ages, please complete the Risk Assessment for Childhood Lead Poisoning & Tuberculosis. Even though it says "Childhood" it is useful for everyone.)

Adults 18 years and older:
  Adult History
  Staying Healthy Assessment
  Risk Assessment for Childhood Lead Poisoning & Tuberculosis
  Surgeries
  Women - Women's History
Adolescents 12-17 years old:
  Pediatric History
  Staying Healthy Assessment 12-17
  Risk Assessment for Childhood Lead Poisoning & Tuberculosis
  What Do You Eat? 8-21
Children 9-11 years old:
  Pediatric History
  Staying Healthy Assessment 9-11
  Risk Assessment for Childhood Lead Poisoning & Tuberculosis
  What Do You Eat? 8-21
Children 4-8 years old:
  Pediatric History
  Staying Healthy Assessment 4-8
  Risk Assessment for Childhood Lead Poisoning & Tuberculosis
  What Do You Eat? 0-8
Children newborn to 3 years old:
  Pediatric History
  Staying Healthy Assessment 0-3
  Risk Assessment for Childhood Lead Poisoning & Tuberculosis
  What Do You Eat? 0-8

 

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›› Knowing your health history helps us give you good care.

We want to know about care you receive other places so we don’t repeat lab tests or procedures unnecessarily or so we don’t give you any medications, over-the-counter medicine, or herbal remedies you may take.

We ask about family, work, living environment, stress, food, and exercise because they impact your well being.

Knowing your family history is important, because some conditions run in families, and it lets us know to watch out for them.

Imperial Beach Health Center and Nestor Community Health Center both have the same phone number: (619) 429-3733.

Whether the clinic is open or closed, a nurse or doctor is available to answer your concerns.

You may need to leave a message, and then a provider will call you back. Patients with the most urgent needs are helped first, and then others.