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Health Department


Adolescent Wellness Forms


  • 2022 Adolescent Wellness Event
  • General Consent Form ENGLISH
  • General Consent Form SPANISH
  • Registration Form ENGLISH
  • Registration Form SPANISH
  • HIPPA Form ENGLISH
  • HIPPA Form SPANISH
  • Sports Physical (English and Spanish)
  • Authorization to Disclose Protected Health Information

  • 2200 4th street
    Baker City, OR 97814
    Phone: (541) 523-8211
    Fax: (541) 523-8242
    TTY: 1-800-735-2900

    Baker County Health Department (BCHD) is available to all, that no individual is excluded from participation, denied benefits, or subject to discrimination on the grounds of race, color, national origin, age, sex, disability, sexual orientation, religion, culture and/or financial status.