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Clinic Registration

Patient Clinic Registration

Are you a new patient? 

If you are a new to CHCS, we will ask you to fill out a new patient questionnaire. View and download the form (PDF). Return it to your clinic via hard copy or call your clinic for the correct email address. 

The Clinic Check-in Process

Once you arrive in one of our clinic check-in areas, a member of our staff will speak with you and:

Ask to see a valid form of photo identification and insurance card.

Verify your contact information.

Make sure you have reviewed and signed the necessary paperwork.

Collect your insurance co-payment or deductible, if required.


What to bring with you:

Drivers license, passport, military ID or other valid photo identification (federally issued ID).

Current medical insurance information, including insurance cards, pre-certification, and other documentation required by your insurer.

All prescriptions and over-the-counter medications you are currently taking, including patches, vitamins or herbal supplements.

List of any allergies, especially to medications and food and/or other substances.


Helpful Information

Release of information form (PDF)

New patient registration form (PDF) (see web form below)

Patient financial and insurance information

Direction and maps

Contact Us

Community HealthCare System 


Patient Clinic Registration

785-889-4241

New Patient Registration Form

  • * - Indicates a required field

  • If you are requesting obstetrical (OB-GYN) care:
  • Please be sure to bring a driver's license and insurance card(s) to your appointment