We're now open to all who are 12 years and older* for COVID-19 vaccines. Schedule yourself here: Use this link to Make An Appointment

  • (747)-266-2666
  • lacommunityhealthcenter@yahoo.com
  • Valley Glen, CA 91405

Home Visit Request

Home Visit Request

Schedule a home visit today!

Fill-out this Intake Form in it’s entirety so we can set a home visit as soon as possible.

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    PATIENT INFORMATION







    TYPE OF VISIT *

    INSURANCE INFORMATION



    REASON FOR VISIT REQUEST *




    If you have selected "Other Reason" for Visit Request, please indicate the reason here.


    PREFERRED FACILITY / HOME HEALTH AGENCY







    LA Community Health Center
    • (747)-266-2666
    • lacommunityhealthcenter@yahoo.com
    • 7335 Van Nuys Blvd #117 Van Nuys, CA 91405

    Business Hours

    • Monday: 9:00 AM - 5:00 PM
    • Tuesday: 9:00 AM - 5:00 PM
    • Wednesday: 9:00 AM - 5:00 PM
    • Thursday: 9:00 AM - 5:00 PM
    • Friday: 9:00 AM - 5:00 PM
    • Saturday: Closed
    • Sunday: Closed

    Location

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