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Lowell Community Health Center makes it easy for you to access and complete patient forms. Start by clicking on the form you need below. If you need immediate attention, such as for prescription refills, please call 978-937-9700 or click here to log into your MyChart account.

Health Benefits Forms

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  • Formulario de Designación De Asistente Certificado Para El Sitio Web

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Lowell Community Health Center
161 Jackson Street
Lowell, MA 01852

Main Number: 978.937.9700
Pharmacy: 978.805.1004

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Lowell CHC is a Health Center Program grantee under 42 USC 254b and an FTCA-deemed facility.

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  • About
    • Who We Are
      • Our Mission
      • Our History
      • The Power to Care
      • ArtUp
      • Back
    • Leadership
      • Board
      • Executive Leadership
      • Back
    • What’s Happening
      • News
      • Events
      • Back
    • Donate
    • Back
  • Health & Wellness
    • Medical Services
      • Adult Medicine
      • Family Medicine
      • HIV Services
      • Metta Health Center
      • OB/Family Planning
      • Patient Walk-In Center
      • Pediatric Medicine
      • School Based Health Centers
      • Back
    • Healthy Community
      • HIV/STI Screening & Treatment
      • Learn About Health Conditions
      • Substance Use Services
      • Back
    • Additional Services
    • Behavioral Health Services
    • Dental Center
    • Eye Care Center
    • Pharmacy
    • Back
  • Patient Resources
    • Become a Patient
      • Contact Us
      • New Patient Information
      • Request an Appointment
      • Back
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      • Community Resources
      • Contact a Patient Advocate
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