Panama City (Dental) - 850-767-3350
DENTAL Form (PDF):

Community Health Center - Bay County
707 Jenks Avenue, Suite A
Panama City, Florida 32405
     FAX: (850) 767-3353

Freeport (Dental) - 850-880-6568
DENTAL Form (PDF):

Community Health Center - Walton County
479 East Highway 20
Freeport, Florida 32439
      FAX: (850) 880-6583

Panama City (Health) - 850-747-5272
MEDICAL Form (PDF):

Community Health Center - Bay County
2309 East 15th Street
Panama City, Florida 32405
      FAX: (850) 747-5274

Freeport (Health) - 850-880-6568
MEDICAL Form (PDF):

Community Health Center - Walton County
479 East Highway 20
Freeport, Florida 32439
      FAX: (850) 880-6583

MEDICAL Form (PDF):  5 pages.  Complete this form prior to your first medical visit to either our Panama City or Freeport facility.

DENTAL Form  (PDF): 5 pages.  Complete this form prior to your first visit for dental services to either our Panama City or Freeport facility.      .

Instructions:

1. Medical Patients:  After you’ve completed your form, call us to schedule your first appointment at the facility of your choice on the center of this web page.  We’ll instruct you on additional documents you may need to bring.

1. Dental Patients:   We need your completed form BEFORE we can make your first appointment.  Fax the completed form to us or mail/deliver to the facility at which you wish to make your appointment listed in the center of this web page.