Enrollment Forms

View & Download Enrollment Forms

INTAKE FORM

Download (PDF, 110KB)


INTAKE FORM - Spanish

Download (PDF, 27KB)


HEALTH QUESTIONNAIRE

Download (PDF, 110KB)


HIPPA

Download (PDF, 168KB)


DEBIT FORM

Download (PDF, 81KB)


DEBIT FORM - Spanish

Download (PDF, 110KB)


ARBITRATION FORM

Download (PDF, 1.03MB)


Is The Practice Right for Your Family?

Abigail Loves it at The Practice

What people are saying about us...

I love this doctor and his staff. The place has an atmosphere of peace. The staff is compassionate and efficient. I was seen right at my appointment time. And the price is right!
Even with my pre-existing issues he was happy to take me on as a patient.
Kat

I would recommend Dr. Mensink and I already have. Every one of my questions was answered thoroughly. The doctor was friendly, and so what his staff.
R - Pastor

Dr. Mensink really cares about his patients. He talks to you directly, very factual. He listens and does whatever it takes to figure out the prognosis. His new office "The Practice" proves that he is trying to make it a better world. I would recommend him to anyone.
Merrylynn

Elite Medical Services at Membership Club Prices

Follow Us

Share This Page


2920 F St. Suite D7 - Bakersfield CA 93301
Call Us: (661) 871-3300

Disclaimers