Online Registration

If you are a new patient or have not visited CHCL in the last 12 months, please continue and complete the required forms below.

* If you meet the criteria and do not complete the forms this will cause delays with your appointment request.

If you have completed the forms, or have been seen at CHCL in the last 12 months, you may request an appointment.

How It Works

To expedite patient screening, CHCL is providing digital versions of the screening forms. You will need to fill out all of the following forms.

  • Enrollment Form
  • Consent To Treatment Form
  • Patient & Center Rights and Responsibilities Form
  • Learning Assessment
  • Migrant Seasonal Determination Form
  • Notice of Privacy Practices Form
  • Privacy Health Care Services Program Form
  • Patient Portal Consent Form
  • Telehealth/Telemedicine Form
Please allocate at least one hour to finish completing all the forms. 
Click the form button below to begin the enrollment process.

Need a Doctor for a Check-Up?

Just make an appointment and we will take care of the rest.

The Community Health Center of Lubbock

Contact Information

CHCL Main Clinic
Address: 1610 5th Street, Lubbock, Texas 79401
Phone: 806-765-2611
Fax: 806-765-2637
Notice of Deemed Status:
This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals. For more information, see