Patient Registration Form & Consent to Treat_2026-Spanish

May 5, 2026 by Paul Detzer

The Community Health Centers of Burlington (CHCB) is a 501(c)(3) non-profit and Federally Qualified Health Center funded in part through a grant from the U.S. Department of Health & Human Services (HHS) and generous community support. CHCB is a Health Center Program grantee under 42 U.S.C. 254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n). This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

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