Welcome to the Wisconsin Association of Free and Charitable Clinics (WAFCC) and Volunteer Healthcare Provider (VHCP) Program Applications.
WAFCC and the Wisconsin Department of Health Services VHCP Program have partnered to streamline the application process for WAFCC Members and VHCP Participants. In other words, WAFCC Members and VHCP Participants will now only need to submit one application to apply for either or both programs.
Additionally, this application was created with the help of Second Opinions, a consulting group of medical students at Northwestern University. In addition to registering you for either/both of the above programs, the information you submit populates a valuation tool that will determine the true value of healthcare services provided by FCCs throughout Wisconsin.
Below you will find two applications. Please read the instructions carefully to ensure your correct enrollment. Thank you for your time in completing this process. Please contact WAFCC Executive Assistant, [email protected] if you have any questions or feedback.
Sincerely,
Jaime Olson WI Primary Care Program Coordinator
Dennis Skrajewski WAFCC Executive Director
Additionally, this application was created with the help of Second Opinions, a consulting group of medical students at Northwestern University. In addition to registering you for either/both of the above programs, the information you submit populates a valuation tool that will determine the true value of healthcare services provided by FCCs throughout Wisconsin.
Below you will find two applications. Please read the instructions carefully to ensure your correct enrollment. Thank you for your time in completing this process. Please contact WAFCC Executive Assistant, [email protected] if you have any questions or feedback.
Sincerely,
Jaime Olson WI Primary Care Program Coordinator
Dennis Skrajewski WAFCC Executive Director
Please note, these applications will take you ~ 45-60 mins to complete.
1. Free and Charitable Clinic (FCC) Application
(WAFCC Membership and/or VHCP Enrollment)
All FCCs must submit this application to become a member of WAFCC and/or to enroll for VHCP coverage. This application allows your clinic the opportunity to join both or op-out of one.
2. Non FCC Organization Application
(VHCP Enrollment Only)
All Non FCCs must submit this application to enroll for VHCP coverage. Please do not use this application to enroll for coverage if your organization is a FCC (instead use application #1 above).
Questions, Comments, Concerns?
Contact WAFCC's Executive Assistant Heather Ule for all inquiries.
This project was funded in part by a grant from the Wisconsin Department of Health Services, Primary Care Program.