Online Registration
Notice:
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 (no visit last 12 months) 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 online.
Frequently Asked Questions
Do i need to register online?
No. But you will need to fill out the required forms at our clinic. The online registration process is to save time, you may also download the forms and pre-fill them.
How long does online registration take?
It takes 30 minutes to complete the online registration process.
How does it work?
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 Form
- Migrant Seasonal Determination Form
- Notice of Privacy Practices Form
- Privacy Health Care Services Program Form
- Patient Portal Consent Form
- Telehealth/Telemedicine Form
The Online Registration will walk you through the process and display your completion progress. Once you submit your completed forms, our staff will receive them and begin registration for you.