WELCOME TO COMMUNITY!   (haga clic aquí para la versión en español)
We are happy to have you as our Member. Community is dedicated to providing you great health care. We also want to help you take charge of your own health! Please take our Health Risk Assessment. We will keep your answers private and only use them to improve the care that we give you. Fill out the survey and submit. We will review it and contact you if we see any potential issues. In addition, share your results with your doctor.

Thank you for helping Community serve you better!

MARKETPLACE MEMBERS:
Take your Health Risk Assessment by logging in to your Member Portal account at memberportal.communityhealthchoice.org.
Don’t have an account? Setting one up is easy and takes less than five minutes.

*Member ID:
*First Name:  
*Last Name:  
*Phone Number:  
*Date of Birth:
                        
*Gender:  
*Weight (in pounds):    
*Height:   Feet:        Inches:   
         
My Health
*When was your last checkup? Month: Year:Don't remember/Never had
*Last Colonoscopy? (If over 50+ years)? Month: Year:Don't remember/Never had
*When was your last tetanus shot? Month: Year:Don't remember/Never had
*Has a health care provider ever said you have had any of the following?
(Please check any that apply.)
       
     
   
*Which describes your blood pressure? (Please check one.)  




Blood Pressure Reading:  / 
  
  
*Which describes your cholesterol?  



*Describe your tobacco use: