Find the English Consent Form here.

Encuentre el Formulario de Consentimiento en Español aquí.

You may fill out this form electronically, or print the form and scan it.*

Upon filling out the Consent Form, please send the electronic document/scanned document via email to: CommunityOutreachRN@PUCSD.org or bring your completed form with you on your scheduled clinic date.

*If you cannot fill out the form electronically, scan the form, or print the form, consent forms will be available to you on the day of your clinic.