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Newsletters
FALL 2010 Newsletter
Summer 2010 Newsletter

LCHC Providers

Michael Rosenfield, M.D.
Jennifer Laughlin M.D.
John Njenga, PA-C
Shawna Stallcop, FNP
Angela Enos, PA-C
Karen Bennett, PHD,PMHNP

FORMS

Forms updated on 10/25/10

Welcome Information
UDS Demographics
Insurance Form
Acknowledgment and Consent
Pediatric Intake Form
Authorization to Use/Disclose Health Information
Release of Information Relating to HIV Antibody Testing
Disclosure of Medical Records - Drug & Alcohol
Financial Policy
Patient Medical History
Patient Registation (updated 10/2009)
Privacy Notice
Discount Fee Policy & Procedure
- Discount Policy & Procedure
- Discount Fee Application (updated November 2009)
- Discount Fee Schedule (updated April 2011)

To Make an Appointment:

Phone:
(541) 536-3435

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