Patient Portal, Forms and Resources

Patient Portal

Mountain Health Center’s patient portal promotes better communication with your provider by offering a secure, convenient way to manage your personal health care.

Patient Forms

Sliding Fee Discount:

Are you eligible to receive up to a 40% to 90% discount for medical care and 20% – 80% discount on basic dental care?

Mountain Health Center and Mountain Health Dental Care offers a Sliding Fee Discount Program. Eligibility is purely income dependent and does not require health insurance nor does it matter what company health insurance you have.

Ready to apply? Applications are available in office or click on the link below.

Download our Sliding Fee Discount Program Application

 Please call (802) 453-5028, select option 2, then option 4 to find out how you may be eligible for this discount.


Pharmacy Application:

Convenient home delivery at no extra charge with potential savings for patients of Mountain Health Center. Download the PDF application here: Pharmacy-Application

Visit the website for more information:

For questions on the Community Health Pharmacy applications, contact our Outreach office at (802) 453-5028, select option 2, then option 4.

New Patients:

Download our Patient Registration Form

Download our Universal Consent Form

Download our Notice of Privacy Practices

Download our Mountain Health Center & Mountain Health Dental Care brochure



ACTR (Addison County Transit Resources)

ACTR was established in 1992 to create a network of community transportation alternatives that connect the people and places in Addison County. Our goal is to provide services that are safe, reliable, accessible and affordable for everyone.


Addison County Community Trust

The Addison County Community Trust (ACCT) works to provide affordable housing to the low- and middle-income people of Addison County, including working families, seniors, and individuals.


Age Well

Age Well, formerly known as CVAA (Champlain Valley Agency on Aging), partners with you, offering guidance and providing you with the services and support you need, when you need it. Whether information, a meal or full case management services—we can help. Our services are provided to seniors and caregivers, regardless of financial status. Call our Senior HelpLine at 1 800 642 5119 or email us to see how we can help you. No question is too small—if it matters to you, it matters to us.


CDC (Centers for Disease Control and Prevention)

CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.


CVOEO (Champlain Valley Office of Economic Opportunity)

CVOEO addresses fundamental issues of economic, social and racial justice and works with people to achieve economic independence.


CSAC (Counseling Services of Addison County)

A nonprofit agency offering a wide variety of professional mental health and developmental services to the people of Addison County. Serving adults, families and children who may have a diversity of needs, including emotional problems, family issues, substance abuse, serious mental illness and developmental disabilities.


DCF (Department for Children and Families)

Some 200,000 Vermonters (nearly one third of our population) rely on DCF for some type of assistance. The goal of this website is to help you find programs, services, and resources that help the well-being of individuals, children and families in Vermont.


Start the Conversation

Talking is the single most important thing that you can do to prepare for the death of someone you love. Your local non-profit Visiting Nurse Associations and Home Health and Hospice agencies have prepared helpful materials, including forms for completing an advance directive, and resources to help you start the conversation with your loved ones.


HOPE (Helping Overcome Poverty’s Effects)

The Addison County Community Action Group (ACCAG), doing business as HOPE (Helping Overcome Poverty’s Effects,) is your locally controlled, locally funded poverty relief organization. We have been serving Addison County since 1965, with a broad range of programs and services. Our Vision is that all people in Addison County have access to the tools and resources necessary to meet their own basic needs.


SASH (Support and Services At Home)

The SASH Program is designed to provide personalized coordinated care to help adult participants stay safely at home regardless of their age or residential setting. SASH communities include a care coordinator and wellness nurse who work in partnership with a team of community providers to assist SASH participants.


Vermont 2-1-1

Vermont 2-1-1 provides all people in Vermont with free access to community resources through information and referral. This access includes personal assistance by telephone and online through a searchable database of services, including the following: Child Care Resources, Clothing and Thrift Shops, Crisis Services, Domestic and Sexual Violence Services, Food Shelves and Nutrition Programs, Alcohol and Drug Programs, Legal Assistance, Youth and Family Services, and more! Just dial 2-1-1!


Vermont Health Connect

Vermont Health Connect offers a new way to choose a health plan that fits your needs and your budget. Both private and public plans are available and we have all the information you need to find the plan that’s right for you – all in one place.