menu trigger  menu trigger
Thomas Chittenden Health CenterThomas Chittenden Health Center
Monday - Friday 8am - 5pmSaturday a.m. for acute visits802-878-8131Contact us586 Oak Hill RoadWilliston, VT 05495
  • Home
  • About Us
    • Mission and History
    • Core Values
    • Inclusivity
    • Independent Practice
    • Contact Us
  • Services
    • Our Practice Model
    • Care Coordination
    • Medical Services
    • Laboratory and Imaging Services
    • Mental Health and Social Services
    • Nutrition and Diabetes Education Services
  • Providers
  • Patient Info
    • Apointment Info
    • Forms
    • Patient Education
    • Billing Information and Online Payment
  • Become a Patient
  • Patient Portal

Patient Information

Keeping you healthy and happy!

Online Forms

Complete these forms on our secure online platform.

Online form links

  • Records Release Form
  • Consent to Release Protected Health Information to Family and Friends
  • Adult Health History Form
  • Child Health History Form
  • Workers Compensation Authorization Form
  • Auto Insurance Authorization Form
  • TeleHealth Informed Consent Form

Forms to Download

These PDF forms are available to fill out and print.

Downloadable PDF forms

  • Records Release Form
  • Consent to Release Protected Health Information to Family and Friends
  • Adult Health History Form
  • Child Health History Form
  • Telehealth Informed consent
  • Workers Compensation Authorization Form
  • Auto Insurance Authorization Form

Policies


  • Payment Policy
  • Privacy Policy
  • What is covered at a Physical Exam


New to TCHC?

Become a patient »


Current Patient?

Log into our Patient Portal »


© Thomas Chittenden Health Center • Website Privacy Policy

  • Mon–Fri 8am – 5pm
    Sat/Sun acute visits
  • (802) 878-8131
    Contact us
  • 586 Oak Hill Rd.,
    Williston, VT 05495
  • Online Bill Payment

Follow us on Facebook

Wi-fi available on site
*If this is a medical or mental health emergency, please call 911*