Patient Portal Request Activation

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In Order To Have A Patient Portal Account With Providence Community Health Centers, You Will Need To Already Be A Patient At One Of Our Providence Community Health Center Locations. If You Have Never Been Seen At Providence Community Health Centers Or Have An Appointment Scheduled To Be Seen For The First Time, Please Do Not Fill Out This Form. You May Request Access To Your Patient Portal Account After Your First Appointment/Visit.

First Name *

Last Name *

Email *

Phone Number *

Date of Birth *

Address *

City *

State / Province / Region *

Postal / Zip Code *

Who will use this account? *

Are you requesting a new patient portal account? *

Please describe your request in detail *

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375 Allens Ave. Providence, RI 02905 | Find Clinic
Phone: 401-444-0400 | Contact Us

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Manage Your Health Online, Anytime.
You Can Connect With Your Health Care Team Through A Convenient, Safe, And Secure Environment.