Submit your questions about the Health Center Program

BPHC Contact Form

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Please give us your information

After entering your name and email address, we’ll look you up in our system. If you have contacted the BPHC Helpline before, and your contact and organization information is complete, you’ll be asked to verify your information and then submit your question or request.

If you have never contacted the BPHC Helpline or your contact information is incomplete, you’ll be prompted to enter your contact and organization information. This will help us to update our records.

Form Progress

If you’d like to inquire about a ticket you previously submitted, please contact Health Center Program Support at 1-877-464-4772.