This page contains links to BJHCHS Agency Forms. Please click the appropriate link to begin downloading.
Please note, some forms may take a short time to download.
HR Forms
- 90 Day Evaluation
- Authorization for Background Check
- Authorization to Release Malpractice liability Coverage Information
- Business Associate Contract
- Incident Report
- General Calendar
- BJHCHS 2022 Pay Period/Holiday Schedule
- Other HR forms
Finance Forms
HIS Forms
- Dental Insurance Verification Form
- Insurance Verification Form
- Short Form Registration
- Short Form Registration Spanish
- Patient Update Form (English/Spanish)
- Other HIS Links
Medical Record Forms
- Release of Patient Records Request
- Release of Patient Records Request Spanish
- Request for Patient Record
- Request for Patient Record Spanish
- Restricted Release of Information
- Restricted Release of Information Spanish
Purchasing & Facilities Forms
Medical Forms
- Behavioral Health Statistics Form
- BCN Form
- Foot Screening
- Medication Error Report Form
- School Based Forms
- Other Pediatric Forms
Dental Forms
- CROWN-AND-BRIDGE-CONSENT-FORM
- ENDO-CONSENT
- Periodontal-Treatment-Refusal
- Post-Op-Procedures
- Complete-and-Partial-Denture-Consent-Form
- Dental Treatment Plan
- Dental Health History Form
- Dental Lead Apron Form
- Dental Peer Review Form
- Dental Peer Review Checklist
IT Forms
Program Forms
Peer Review
Adult
- Adult Med Diabetes
- Adult Med HIV
- Adult Med HTN
- Adult Med General
- Ob Gyn Peer Review Tool
- Ob Gyn Peer Review Tool non pregnant patient