Welcome to the RCMS family! It is our mission to provide the highest quality healthcare to all of our patients. It is important that all forms in your file are accurate and up to date. Please help us keep your records up to date by reporting any recent changes. First time patients, speed up the registration process by filling out these forms and bringing them to your first appointment.
Please also complete the patient Medical History form.
Parent or Guardian Consent to Treat Minors
By law, any child under the age of 18 years old cannot be seen by a doctor without consent from a parent or legal guardian. This form gives permission to any RCMS Provider to treat the minor in accordance with the provisions of Family Code Section 6910.
To be eligible, please provide proof of income within 30 days of submitting your application. Acceptable forms include:
If you are unable to provide RCMS with one of the approved forms of income documentation, please call 707-882-2189 for assistance.
Eligible patients in our service area (Elk to Timber Cove) are eligible to apply for the Sliding Scale Discount program. To apply fill out the Patient Financial Screening Form below: