{"id":544,"date":"2022-05-31T14:00:17","date_gmt":"2022-05-31T19:00:17","guid":{"rendered":"https:\/\/cherryhealth.org\/recursos-para-pacientes\/formularios\/"},"modified":"2025-08-26T13:12:35","modified_gmt":"2025-08-26T18:12:35","slug":"formularios","status":"publish","type":"page","link":"https:\/\/cherryhealth.org\/es\/recursos-para-pacientes\/formularios\/","title":{"rendered":"Formularios"},"content":{"rendered":"\r\n<section class=\"hero\" id=\"hero-block_acb19ef8785e58128657767ff69fec3a\">\r\n    <div class=\"hero-grid\">\r\n        <div class=\"hero-text\">\r\n                        <h1 class=\"hero-headline\">\r\n                                    <div class=\"hero-headline-large\">Formularios<\/div>\r\n                            <\/h1>\r\n                            <div class=\"hero-teaser\"><p>Revise o imprima y rellene los formularios m\u00e1s utilizados por los pacientes haciendo clic en los siguientes enlaces.<\/p>\n<\/div>\r\n                    <\/div>\r\n\r\n        \r\n    <\/div>\r\n<\/section>\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2022\/08\/Telehealth-Informed-Consent-1825Csp_fillable.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Consentimiento informado para la telesalud<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2025\/08\/Consents-and-Acknowledgements-430Psp.pdf\">Consentimientos y reconocimientos<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2022\/08\/Commercial-Insurance-Medicaid-Waiver-710Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Formulario de exenci\u00f3n de seguro comercial \/ Medicaid  <\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/04\/Sliding-Fee-Program-Application-13020Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Solicitud del Programa de pagos variables seg\u00fan sus ingresos<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2022\/08\/Financial-and-No-Show-Information-22005Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Informaci\u00f3n financiera y de no presentaci\u00f3n<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2022\/08\/Adult-Consent-for-Controlled-Substances-23100C.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Consentimiento de los adultos para las sustancias controladas<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/08\/Adult-Consent-for-Controlled-Substances-23100Csp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Consentimiento del menor para sustancias controladas<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2022\/09\/Authorization-for-Release-of-Health-Information-22045Psp_fillable.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Autorizaci\u00f3n (permiso) para divulgar informaci\u00f3n sanitaria<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" style=\"padding-top:var(--wp--preset--spacing--30);padding-bottom:var(--wp--preset--spacing--50)\"><strong>Formularios del Programa Escolar<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/07\/School-Based-Health-Center-Consent-4165Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Formulario de Consentimiento del Centro De Salud Escolar<\/a><\/strong><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/06\/School-Based-Health-Center-Consent-Counseling-Services-4170Psp-Fillable.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Formulario de Consentimiento del Centro de Salud Escolar Servicios de Asesoramiento<\/strong><\/a><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2023\/05\/Student-Sliding-Fee-Program-Application-13021Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Solicitud de estudiante para el Programa de Tarifas Basadas en el Ingreso<\/a><\/strong><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/04\/Authorization-for-Release-of-Information-to-Family-or-Friend-SBHC-805Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Autorizaci\u00f3n para divulgaci\u00f3n de informaci\u00f3n a famailiares o amiogos<\/strong><\/a><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/05\/Screening-Checklist-for-Contraindications-to-Vaccines-495Csp-Fillable.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Lista de verificaci\u00f3n de detecci\u00f3n de contraindicaciones para vacunas<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/05\/Refusal-To-Consent-to-Vaccination-Child-and-Adolescent-455Csp-Fillable.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Negaci\u00f3n de Consentimiento a la Vacunaci\u00f3n Ni\u00f1os y Adolescentes<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/04\/MHSAA-Spanish-Form.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Michigan High School Athletic Association (MHSAA) Historal M\u00e9dico<\/a><\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/04\/MHSAA-Spanish-Form.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Consentimiento de tratamiento para el programa dental vinculado a la escuela<\/a><\/strong><\/li>\n\n\n\n<li><a href=\"https:\/\/cherryhealth.org\/wp-content\/uploads\/2024\/03\/School-Linked-Vision-Treatment-Consent_Fillable-20315Psp.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Consentimiento de tratamiento para el programa de la vista vinculado a la escuela<\/strong><\/a><\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Descargue nuestra solicitud para el Programa de pagos variables seg\u00fan sus ingresos y otros formularios de uso com\u00fan para pacientes.<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":295,"menu_order":5,"comment_status":"closed","ping_status":"closed","template":"template-sidebar.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-544","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/pages\/544","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/comments?post=544"}],"version-history":[{"count":0,"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/pages\/544\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/pages\/295"}],"wp:attachment":[{"href":"https:\/\/cherryhealth.org\/es\/wp-json\/wp\/v2\/media?parent=544"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}