Adult Medicine

Patient Registration Forms

New to our Health Center? If you would like to expedite your wait time, you may download our patient registration forms here and fill them out prior to your appointment date and time!

To submit any of the forms below. Questions should be directed to Felicia at 760-365-9305 extension 1511.

  • 1. Bring forms to your first appointment;
  • 2. Mail the forms to 58375 Twentynine Palms Hwy, Suite B, Yucca Valley CA 92284
  • 3. Fax the forms to 1-866-732-0113;
  • 4. Email the forms to




    REGARDING FINANCIAL SUPPORT: Morongo Basin Community Health Center provides affordable access to primary and specialty care. Most private insurances, Medicare and Medi-Cal / IEHP are accepted. A sliding fee scale is available to those with fixed or no income so that anyone may be seen for a nominal cost. We also provide assistance in completing applications for medical insurance benefits.


The Morongo Basin Community Health Center provides the following care at locations in 29 Palms and Yucca Valley. To make an appointment, call 760-365-9305