Rural Health / Sliding Fee Application
Our office is a certified Rural Health Clinic. Rural Health Clinics were established in 1977 to provide primary and preventative care to rural areas. As a Rural Health Clinic we are required to use a team approach between the physicians and physician assistants to provide services.
We provide a discounted Sliding Scale fee schedule to uninsured or underinsured based on household size and gross income in accordance with the Federal Poverty Guidelines. No one will be denied access to services due to inability to pay.
Please use the following form to apply for the Sliding Scale discount. Proof of income must be submitted with the application. If you are approved, you will be required to renew on an annual basis.
Self Pay Sliding Fee Application
The following links can be used to apply for medical benefits in your state of residence.
Michigan Medicaid www.michigan.gov/mdch/0,1607,7-132-2943_4860-35199--,00.html
Wisconsin Medicaid www.dhs.wisconsin.gov/badgercareplus/