angle-left
angle-right
angle-right
Community Healthcare Network

Patient Forms

Please complete the New Patient Forms below using the fields and email to the site you are scheduled for your visit.

OR

Print and fill out by hand and mail to the site you are scheduled for your visit.

Locations

South Bronx:
975 Westchester Ave
Bronx, NY 10459
[email protected]

Tremont:
4215 Third Ave, 2nd Floor
Bronx, NY 10457
[email protected]

Crown Heights:
1167 Nostrand Ave
Brooklyn, NY 11225
[email protected]

East New York – Dr. Betty Shabazz:
999 Blake Ave
Brooklyn, NY 11208
[email protected]

East New York HUB:
2581 Atlantic Ave
Brooklyn, NY 10459
[email protected]

Williamsburg:
94-98 Manhattan Ave
Brooklyn, NY 11206
[email protected]

Harlem:
81 West 115th St
New York, NY 10026
[email protected]

Lower East Side:
150 Essex St
New York, NY 10002
[email protected]

Washington Heights:
511 West 157th St
New York, NY 10032
[email protected]

Jamaica:
90-04 161st St, 5th Floor
Jamaica, NY 11432
[email protected]

Long Island City:
36-11 21st St
Long Island City, NY 11106
[email protected]

Sutphin Boulevard:
97-04 Sutphin Boulevard
Jamaica, NY 11435
[email protected]

All Community Healthcare Network health centers and offices will be open on Tuesday, February 24, 2026. Our mobile health clinics will not be operational due to weather conditions.

Update: Parent Portal Access

Dear Parent or Guardian,

We would like to inform you that as of September 1, 2026, access to your child’s Healow account through Community Healthcare Network (CHN) will be limited to viewing immunizations and referrals for all patients ages 12 and older. This change is required to comply with the Health Insurance Portability and Accountability Act (HIPAA) and New York State laws that protect minors’ rights to confidentiality.

You may still request your child’s medical records by calling or visiting your health center.

If you have any questions or would like more information, please speak with our front desk staff during your next visit or go to: chnnyc.info/nylaw

Thank you,
Community Healthcare Network (CHN)