- The Cafe
Medical Records Requests
For medical records to Riverside Medical Clinic from another healthcare provider: In order for another healthcare provider to forward your medical records to us, they will need a medical records release form completed and submitted to them. You can download the form here.
For medical records from Riverside Medical Clinic to another healthcare provider:
In order for us to release your medical records to another healthcare provider, we will need a medical records release form completed and submitted to us. You can download the form here.
“Third Party Consents for Minors”
This form is completed and returned by a parent or guardian to give consent to a caregiver to seek medical care for a minor child. You can download the form here.
Staying Healthy Assessment Forms
As per MMCD Policy Letter 13-001, Staying Healthy Assessment (SHA) forms must be administered to new patients during the Initial Health Assessment (IHA) and periodically thereafter as the patient enters a new age category. SHA forms may be downloaded and printed in multiple age categories and languages below or from the DHCS website. http://www.dhcs.ca.gov/formsandpubs/forms/Pages/StayingHealthy.aspx