High Plains Community Health Center : Patient Portal Registration

Patient Portal Registration

Please complete this form if you have never registered for the Patient Portal. If you have registered please log in via the Patient Portal Login button with your user name and password given in your "welcoming email" you received. If you cannot remember your user name or password please email Portal Support or call our office at 719-336-0261. Thank you.
	Name
	Date of Birth
	Phone Number
	Your e-mail address will be your log in name. Once we have created your account you will receive an e-mail with the link to the portal. Please allow 24-48 business hours for us to process your request. You will be asked to create your own password once you enter the portal for the first time.
	Email Address
	If you are the legal guardian or have power of attorney for a family member or friend, you may also have access to their portal. We must have proper documentation on file to grant these requests. Please give us the following information for any additional patients for whom you would like viewing access. Note: If we do not have proper documentation on file to view additional patients they will not show when you log into your portal. You will need to contact our office and provide the required documentation.
	Patient Name #1
	Date of Birth
	Authority
	Patient Name #2
	Date of Birth
	Authority
	Patient Name #3
	Date of Birth
	Authority
	Please call 719-336-0261 if you have any questions or need help navigating the portal.