Enrollment Form

Complete your form before your first visit to CHC and then annually moving forward.

Enrollment Form - Parent Guardian

Please have your parent or guardian complete your form before your first visit to CHC and then annually moving forward.

Medical Records Release

Complete the Medical Records Release form when you need CHC to release your medical records to someone outside of the clinic, or if you need CHC to request records from someone else. There are two forms; Ask us for questions/clarification.

TB Risk Assessment Outreach Form

TB Assessment English

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Chinese

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Arabic

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.

TB Assessment Portuguese

Complete the TB Assessment Form in your language of choice if you are an international student coming to CHC for your TB clearance appointment for the first time, or if you’ve been back to your home country for 30 days or more.