Below are my two model classes
class Patient < ActiveRecord::Base
belongs_to :user, :dependent => :destroy
has_many :enrollments, :dependent =>
Instead of
:client_id
in the collection_select, try
"client_id[]"
The second form specifies that you're accepting an array of IDs for the attribute rather than a single one.
Here's a good resource on the usage of the select helpers in forms: http://shiningthrough.co.uk/Select-helper-methods-in-Ruby-on-Rails