Forms

Solace New Patient Request Form

Solace New Patient Request Form

Thank you for choosing our office. In order to serve you properly we will need the following information. All information will be held confidentially.

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Solace Cancer Care Authorization for Use or Disclosure of Protected Health Information

Authorization for Use or Disclosure

By downloading, completing and returning this form to Solace Cancer Care, you give us permission to share your health information with other health care providers who need it to help us in your treatment.

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Solace Cancer Care Individual Health Information Consent Form

Individual Health Information Consent Form

This document will give Solace Cancer Care your permission to use and disclose your health information for treatment, payment, and/or health care operations.

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Solace Cancer Care Financial Policy

Financial Policy

All patients must read and sign the Financial Policy form.

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Redding

310 Hartnell
Redding, CA 96002
530-244-2223
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Mt. Shasta

902 Pine Street
Mt. Shasta, CA
96067
530-926-6855
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Get Directions to Solace Cancer Care