The mission of Lowell Community Health Center is to provide caring, quality, and culturally appropriate health services to the people of Greater Lowell, regardless of their financial status. We are committed to enhancing the health of our community and to empowering each individual to maximize their overall well-being.

Achieving Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) status means that Lowell Community Health Center has been recognized for complying with rigorous national performance standards that promote quality healthcare delivery. JCAHO accreditation is one more way Lowell Community Health Center shows it is dedicated to improving healthcare services for the people of Greater Lowell.

Main > Patient Pre-Registration

To ensure that you are seen promptly please complete the Pre-Registration Form before your first visit to Lowell Community Health Center. You may download and print out an electronic copy of the form by clicking on the Pre-Registration Form button to the left or below.

Please fill out this form to your best ability making sure that all information is accurate and complete. Please write your answers clearly so that they can be easily read. Bring the form with you when you arrive at the Health Center for your first appointment.

You will need the following information to complete this form:

• Your insurance card (if you do not have insurance, see below).
• Referral letters form other physicians (only if applicable).
• Name and phone number of an emergency contact.
• Employment information

Adult Pre-Registration Form

Pediatric Pre-Registration Form

If you would like to apply for health coverage, you may speak with one of our Health Benefits Coordinators before or after your visit with your medical provider. Health Benefits Coordinators can help you with the application process and determine your eligibility for free or reduced cost care.

You will need to bring the following information with you when you visit a Health Benefits Coordinator:

• Proof of income -2 recent weekly or bi-weekly pay stubs.
• Proof of immigration status - green card, visa, granted asylum, etc. You may qualify for health coverage regardless of your immigration status.