Forms
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.
Download Solace New Patient Request Form »
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.
Download Authorization for Use or Disclosure »
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.
Download Individual Health Information Consent Form »
Financial Policy
All patients must read and sign the Financial Policy form.
Download Financial Policy »
Dr. Philben's Office
963 Butte StreetRedding, CA 96001
Ph: 530-244-3921
Fax: 530-244-5639

