"It was my first visit to CHCCW to the Quick Care. The front desk staff at the Quick Care, X-Ray & pharmacy were all very friendly and helpful."
"I was a walk-in and was seen almost immediately. The staff was friendly and efficient. I generally dislike visiting medical providers, but they made it as pleasant as it could be."
"I love my provider and her team! They are amazing!"
"I cannot speak highly enough for every staff member and professional I have encountered since I switched to CHCCW for my healthcare."
"The community clinic is awesome. I always get an appointment easily."

Please call for an appointment or questions: (307) 233-6000

For after hours assistance, call: (307) 233-6000

Patient Registration Forms

In order to streamline your patient experience, CHCCW encourages you to fill out our online patient registration forms prior to your visit.

Click the links below to access our Patient Registration Forms for each clinic location.

Casper

Patient Registration Form

Riverton

Patient Registration Form

Lander

Patient Registration Form

Dubois

Patient Registration Form

Behavioral Health Form

Behavioral Health Adolescent Informed Consent for Assessment and Treatment

Adult Informed Consent for Treatment

Adolescent Informed Consent for Treatment – AMHNP

Adult Informed Consent for Treatment – AMHNP

Behavioral Health Disclosure Statement

Dental Form

Our Dental Clinic utilizes separate patient registration forms. Visit our dental page to access these forms.

Sliding Fee scale

Sliding Fee Scale forms and information are available on our Sliding Fee Application page.

Medical Records Release

Click Here for Health Mark Group Medical Records Request
Download our Medical Records Release Form
Download our Mental Health Medical Records Release Form

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