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Indicate Your Clinic Below: Montpelier Independence Mount Pleasant Yerba Buena Gilroy Silver Creek Andrew Hill Foothill Family Clinic La Pala Momentum Monterey Plaza Glenview Story Department/Departamento:  Medical/Medico  Chiropractic/Quiropractico  Dental Optometry/Optometria  Behavioral Health/Consejeria  OB/GYN/Ginecologia y Obstetricia  Name of Patient/Visitor/Nombre del Paciente/Visitante:  Date of Appointment/Fechas:  Time/Hora:  Address/Domicilio:  Telephone/Numero de Telefono:  DOB/Fecha de Nacimiento: Best Time to Call/Mejor Hora para Ilamar:   Please describe the complaint and include any pertinent information, names, titles, etc:   Por favor de dar detalles de su queja. Incluya informacion como nombres, titulos, etc:
Indicate Your Clinic Below:
Montpelier
Independence
Mount Pleasant
Yerba Buena
Gilroy
Silver Creek
Andrew Hill
Foothill Family Clinic
La Pala
Momentum
Monterey Plaza
Glenview
Story
Department/Departamento:
Medical/Medico
Chiropractic/Quiropractico
Dental
Optometry/Optometria
Behavioral Health/Consejeria
OB/GYN/Ginecologia y Obstetricia
Name of Patient/Visitor/Nombre del Paciente/Visitante:
Date of Appointment/Fechas:
Time/Hora:
Address/Domicilio:
Telephone/Numero de Telefono:
DOB/Fecha de Nacimiento:
Best Time to Call/Mejor Hora para Ilamar:
Please describe the complaint and include any pertinent information, names, titles, etc:
Por favor de dar detalles de su queja. Incluya informacion como nombres, titulos, etc:
Patient Complaint Form
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Vision Statement

Foothill Community Health Center envisions a leadership role in comprehensive primary health care services. Our vision is to improve the health, well being, and safety of our community by providing a caring and welcoming health care experience.  Foothill Community Health Center is an integral partner with the community in the promotion of health and wellness education and treatment services.  Our community will have access to high quality affordable health care - a social justice equity service. 
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