On January 3, 2012, Pueblo Community Health Center's registration process changed. You will no longer be scheduled to meet with a Health Benefits Coordinator to renew your CICP card. You can walk-in to our Park Hill Clinic (1302 East 5th Street) or our Pharmacy and Administrative Services Site (110 East Routt Avenue). Please read the list below and make sure you have all items that are needed for registration. When you arrive for your Registration appointment, you will be seen in the order that you check-in. In order to decrease wait times, please bring the correction documentation (see below). Please be aware that the Health Benefits Coordinator will NOT register you and or your family if you have missing documentation—you will be asked to return with all necessary documentation.

For each person in need of medical assistance (self; self & spouse; or self, spouse and children), please provide the following information:

1. Colorado ID or Driver’s License for everyone over age 16;
2. Permanent Resident Cards (if applicable);
3. Birth Certificates for everyone;
4. Social Security Cards/Numbers for everyone;
5. Proof of household income;
6. Vehicle registration(s) and loan statement/receipt if there is a balance owed on vehicle
7. Completed Colorado State Affidavit if spouse not present at time of registration

If you are registering for yourself and children or yourself, spouse and children: please pick-up a Medicaid/CHP+ application prior to meeting with a PCHC Health Benefits Coordinator – DO NOT DATE this form until you meet with the Health Benefits Coordinator. If there are visits that need to be back-dated within 3 months, please bring proof of income for all months of the visit dates.