debacaclinic@plateautel.net     Call Us: 575-355-2414

Patient Forms

De Baca Family Practice has made it easier for first time patients by offering health related forms online.  Please select the appropriate form(s), print them out and bring them to your appointment already completed.  By offering you this option to print the forms at home in advance of your appointment, you will be able to complete them at your own pace. Please print the forms on white paper only.

**PLEASE BRING A LIST OF ALL THE MEDICATIONS YOU ARE CURRENTLY TAKING WITH YOU.  IF IT IS EASIER, SIMPLY PUT YOUR MEDICATIONS IN A BAG AND BRING THEM WITH YOU.  IT IS IMPERATIVE THAT WE HAVE A CURRENT MEDICATION LIST IN ORDER TO SERVE YOU BEST.**

DO YOU NEED MEDICAID OR OTHER INSURANCE?

WE know life changes . . . and our Patient Care Advocate, Liz Stanton, is here to help.   There are many options available to patients today and the systems can be overwhelming.  Liz is ready to help you fill out the necessary forms, compile the correct documentation and navigate the various options.  

Call Liz today at 575-355-2424 and schedule an appointment to get your health care coverage in place OR Click on the red button below to submit an online request for more information.

Invest in your health – Invest in yourself.