Community Health Access Network

Due to the increased number of projects and growth occurring at the CHAN member sites, CHAN has developed both a Project Request Form and a Report Request Form that need to be submitted as part of the planning process. These forms will assist CHAN member's with defining project and reporting requirements and will also assist CHAN staff with planning to ensure member needs are met. 

It is our hope that these forms will make it easier for our Members to make requests and for CHAN to more effectively track these requests.  If you have any questions please don't hesitate to contact Paul Brimigion, CHAN IT Manager (292-7232) regarding the Project Request Form or Rebecca Roosevelt (292-7241) regarding the Report Request Form.  Thank you for your cooperation!

CHAN Project Request Form

CHAN Reporting Request Form