diff --git a/balancer/balancer.go b/balancer/balancer.go
index df5cc3246b25..ae6df0750fae 100644
--- a/balancer/balancer.go
+++ b/balancer/balancer.go
@@ -152,7 +152,18 @@ type SubConn interface {
 	// indicate the shutdown operation.  This may be delivered before
 	// in-progress RPCs are complete and the actual connection is closed.
 	Shutdown()
+	// RegisterConnectivityListner allows producers to subscribe to subchannel
+	// connectivity state updates. Listener will get updates only till the ClientConn
+	// is closed. It is not guaranteed for listeners to get an update when the
+	// subchannel transitions to SHUTDOWN. Listeners should be unregestered
+	// when they are no longer required. The listener will get called with the
+	// present connectivity state before receiving any other updates.
+	// Registering a listener multiple times without unregistering is a no-op.
 	RegisterConnectivityListner(StateListener)
+	// UnregisterConnectivityListner allows producer to stop receiving updates
+	// on the given listener. If the listener was not previously registered, this
+	// is a no-op. The listener may still receive pending updates that came
+	// before the unregistration request.
 	UnregisterConnectivityListner(StateListener)
 }
 
diff --git a/balancer/pickfirstleaf/pickfirstleaf.go b/balancer/pickfirstleaf/pickfirstleaf.go
index 3a96741d150c..a654906bde9a 100644
--- a/balancer/pickfirstleaf/pickfirstleaf.go
+++ b/balancer/pickfirstleaf/pickfirstleaf.go
@@ -144,6 +144,8 @@ func (b *pickfirstBalancer) newSCData(addr resolver.Address) (*scData, error) {
 	// Start the health check service if its configured.
 	if internal.EnableHealthCheckViaProducer != nil {
 		sd.closeHealthProducers = internal.EnableHealthCheckViaProducer.(func(balancer.HealthCheckOptions, balancer.SubConn) func())(b.healthCheckOpts, sc)
+	} else if b.healthCheckOpts.EnableHealthCheck {
+		b.logger.Errorf("Health check is requested but health check function is not set.")
 	}
 	sd.subConn = sc
 	return sd, nil
diff --git a/balancer_wrapper.go b/balancer_wrapper.go
index 972c77ed0268..ad927d736a28 100644
--- a/balancer_wrapper.go
+++ b/balancer_wrapper.go
@@ -376,11 +376,15 @@ func (acbw *acBalancerWrapper) RegisterConnectivityListner(l balancer.StateListe
 		if ctx.Err() != nil || acbw.ccb.balancer == nil {
 			return
 		}
+		if acbw.connectivityListeners[l] {
+			return
+		}
 		acbw.connectivityListeners[l] = true
 		acbw.ac.mu.Lock()
-		defer acbw.ac.mu.Unlock()
+		state := acbw.ac.state
+		acbw.ac.mu.Unlock()
 		l.OnStateChange(balancer.SubConnState{
-			ConnectivityState: acbw.ac.state,
+			ConnectivityState: state,
 		})
 	})
 }
diff --git a/health/genericproducer/producer.go b/health/genericproducer/producer.go
index 0de212375145..3e9c934a2e24 100644
--- a/health/genericproducer/producer.go
+++ b/health/genericproducer/producer.go
@@ -24,7 +24,7 @@ var producerBuilderSingleton *producerBuilder
 
 type broadcastingListner struct {
 	p         *producer
-	listeners map[balancer.StateListener]bool
+	listeners map[balancer.StateListener]int
 }
 
 func (l *broadcastingListner) OnStateChange(scs balancer.SubConnState) {
@@ -49,7 +49,7 @@ func (*producerBuilder) Build(cci any) (balancer.Producer, func()) {
 	p.connectivityListener = &connectivityListener{p: p}
 	p.broadcastingListener = &broadcastingListner{
 		p:         p,
-		listeners: make(map[balancer.StateListener]bool),
+		listeners: make(map[balancer.StateListener]int),
 	}
 	p.rootListener = p.broadcastingListener
 	return p, sync.OnceFunc(func() {
@@ -88,10 +88,16 @@ func (l *connectivityListener) OnStateChange(state balancer.SubConnState) {
 	})
 }
 
-// RegisterListener is used by health consumers to start listening for health
-// updates. It returns a function to unregister the listener and manage
-// ref counting. It must be called by consumers when they no longer required the
-// listener.
+// RegisterListener allows health consumers to start listening for health
+// updates till the ClientConn is closed. It is not guaranteed for listeners to
+// get an update when the subchannel transitions to SHUTDOWN.
+// It returns a function to unregister the listener and manage ref counting.
+// Listeners must be unregestered when they are no longer required. The listener
+// will get called with the present connectivity state before receiving any
+// other updates. If a listener is registered multiple times, it will receive each
+// update only once. The function returned by all the registration requests must be
+// called to finally unregister the listener. The listener will asynchronously
+// get all the updates that were queued before the unregisteration request came.
 func RegisterListener(l balancer.StateListener, sc balancer.SubConn) func() {
 	pr, closeFn := sc.GetOrBuildProducer(producerBuilderSingleton)
 	p := pr.(*producer)
@@ -104,16 +110,17 @@ func RegisterListener(l balancer.StateListener, sc balancer.SubConn) func() {
 			p.sc = sc
 			sc.RegisterConnectivityListner(p.connectivityListener)
 		}
-		p.broadcastingListener.listeners[l] = true
+		p.broadcastingListener.listeners[l]++
 		l.OnStateChange(p.healthState)
 	})
 	return unregister
 }
 
 // SwapRootListener sets the given listener as the root of the listener chain.
-// It returns the previous root of the chain. The producer must process calls
-// to the registered listener in a passthrough manner by calling the returned
-// listener every time it received an update.
+// It returns the previous root of the chain. The new root will be called with
+// the present connectivity state before any other updates are sent.
+// A cleanup function is also returned which must be called before the calling
+// producer/LB policy shuts down.
 func SwapRootListener(newListener balancer.StateListener, sc balancer.SubConn) (balancer.StateListener, func()) {
 	// closeFn can be called synchronously when consumer listeners are getting notified
 	// from the serializer.If the refcount falls to 0, it can use the producer
@@ -144,6 +151,9 @@ func SwapRootListener(newListener balancer.StateListener, sc balancer.SubConn) (
 
 func (p *producer) unregisterListener(l balancer.StateListener) {
 	p.serializer.TrySchedule(func(_ context.Context) {
-		delete(p.broadcastingListener.listeners, l)
+		p.broadcastingListener.listeners[l]--
+		if p.broadcastingListener.listeners[l] == 0 {
+			delete(p.broadcastingListener.listeners, l)
+		}
 	})
 }
diff --git a/health/producer.go b/health/producer.go
index cc864757f656..94a6c4507fc7 100644
--- a/health/producer.go
+++ b/health/producer.go
@@ -33,6 +33,8 @@ func (l *connectivityStateListener) OnStateChange(newState balancer.SubConnState
 		// Propagate updates down the listener chain.
 		l.p.updateStateLocked()
 	}()
+	// Behave as as an identity function and pass on the connectivity updates
+	// down the listener chain.
 	if l.p.shutdown {
 		return
 	}
@@ -102,7 +104,11 @@ type healthServiceProducer struct {
 }
 
 // EnableHealthCheck enabled the health check service client to perform health
-// checks for the subchannel.
+// checks for the subchannel. It must be called at most once on a subchannel.
+// Once the health check service is enabled, consumers can receive its updates
+// by registering a listener with the generic health producer.
+// It returns a cleanup function that must be called once the health checking is
+// no longer required.
 func EnableHealthCheck(opts balancer.HealthCheckOptions, sc balancer.SubConn) func() {
 	pr, closeFn := sc.GetOrBuildProducer(producerBuilderSingleton)
 	p := pr.(*healthServiceProducer)