Hours of Operation

Monday - Friday 8:00am - 9:00pm with the exception of Wednesday the clinic is open from 8:00am - 12:00pm, and 5:00pm - 9:00pm.

Saturday - 9:00am - 1:00pm

Patient Satisfaction Survey

Youth Mentoring Program

Personal References

Please list the names, addresses, and phone numbers of three people you would like to use as character references (only people you have known for at least a year). Include at least one relative. Any information Youth Mentoring Program gathers from these references will be held as confidential and not released to you, the applicant.
Relative's Name:
Address:
City: State: Zip:
Phone:
Relationship: How long known:
Name:
Address:
City: State: Zip:
Phone:
Relationship: How long known:
Name:
Address:
City: State: Zip:
Phone:
Relationship: How long known:
Please return or mail this application and the items listed above to Youth Mentoring Program, First Nations Community HealthSource,5608 Zuni Rd SE, Albuquerque, NM 87108.