Patient Forms

MCH makes it easy for you to access and complete patient forms. Start by clicking on the form you need below. Please have all the forms completed prior to your arrival.

If you select one of our PDF Forms

1. Print the form, fill it out, and sign it.
2. Return by mail to:
   Mountain Community Health
   ATTN: Health Information
   61 Pine St.
   Bristol, VT 05443
   or fax to Medical 802-453-6105. Dental 802-453-2358
3. Do not email the forms.

If you have questions, please call 802-453-3911.

• Patient Registration Consent Form 
• Registration Form 
• Release of Information Form  
• Sliding Fee Brochure 
• Sliding Fee Scale Form 
• Mountain Community Health Brochure