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MOUNTAIN VALLEYS HEALTH CENTERS HEALTH HISTORYName: DOB: Today's Date: Please check and comment on all that apply. Any additional detail is helpful year, right/left, etc. Past or Current Medical HistorySurgical
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Mountain Valleys Health Centers is a network of community health centers providing medical services to individuals and families in rural areas.
All patients who receive medical services from Mountain Valleys Health Centers are required to provide accurate information for filing purposes.
Patients can fill out Mountain Valleys Health Centers forms in person at the center, online through the patient portal, or over the phone with a representative.
The purpose of Mountain Valleys Health Centers is to provide accessible and affordable healthcare services to rural communities.
Patients must report their personal information, medical history, insurance details, and any medications they are currently taking.
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