Donate Today

Enrollment Process & Requested Forms

How do I apply?

Step 1 – Choose where you would like to receive your primary care from our Provider Directory. If you would like assistance in selecting a primary care location or determining your eligibility, you can contact CHAP at 1-888-929-CHAP(2427). If you qualify, we can begin the enrollment process over the telephone to save you time when you visit your primary care location.

Step 2 – Schedule an eligibility/financial counseling appointment at your preferred primary care location. If you are already a patient at a participating organization, simply let them know you want to become a CHAP member. Trained staff at that site will help you schedule an appointment to come in, meet with enrollment staff, and apply to become a member.

Step 3 – For your appointment, you will be asked to bring the following materials to your primary care site:

  • Photo ID (if you have one)
  • Proof of Residency in Cuyahoga County (This can include any bills or printed mail addressed to you within the past 60 days.)
  • Proof of Family Size (Birth certificates for your children under the age of 18, and marriage or divorce documents.)
  • Proof of Income (This can include a most recent U.S. Income Tax Return, e.g.: IRS Form 1040, 1040A, 1040EZ, 1099, or pay stubs for the last three months, or benefit letters from pensions, social security or workman’s compensation.)

CHAP will not turn down applicants based on immigration status.