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Patient Forms

Patient Forms at Burbank Urgent Care in Burbank, CA

Expedite your visit to Burbank Urgent Care services by having your forms ready. Submit your new online patient registration form before you arrive. For more information, make a reservation or contact us.

Urgent Care Pre-Registration & Medical History Forms

To speed up the registration process download and fill out the Pre-Registration & Medical History Forms before you visit the clinic.

Los Angeles County COVID-19 Form

If you are coming in for Rapid or PCR testing, please complete and print out this form to bring in to the clinic.

Notice to all Copy Services

All subpoenas / Authorization to copy must be served on DMS, Inc.
This medical office is not authorized to accept service of any Subpoenas