Patient Forms

Lowell Community Health Center makes it easy for you to access and complete patient forms and sign up for the Patient Portal.

1. Simply click on the appropriate form, below.
2. Print the form, fill it out, and sign it.
3. Return it to us by mail to:

   Lowell Community Health Center
   ATTN: Health Information
   161 Jackson Street
   Lowell, MA 01852

   or fax to 978-221-6728. If you have Adobe, you may also be able to complete electronically and email to Health Information. 

We will respond to your request within three business days. If you have questions, please call 978.937.9700 and ask to be connected with Health Information.