Please print out and complete this paperwork, and then bring it with you to your appointment.
This form gives CHC legal permission to treat your child in case you cannot accompany him or her to CHC for treatment.
This describes how your medical information may be used and/or disclosed and how you can get access to your medical information
Community Health Connection release of medical information can be used to request a copy of your medical records.
Please complete and email firstname.lastname@example.org or fax to 918.442.2036 if you are interested in any of our current employment opportunities.
Please complete and email email@example.com or fax to 918.442.2011 if you are interested in becoming a member of our Board of Directors.