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Forms
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.