Membership is for Wisconsin free and charitable clinics.Free and charitable clinics are safety-net healthcare organizations that provide medical, dental, behavioral health and pharmacy services to uninsured/underinsured residents. The clinics are 501c3 tax-exempt organizations or operate as a component of a 501c3 organization.
Please complete the 3 steps below to ensure your membership enrollment.
Step 1: Membership & Renewal Application
The Membership Application and Renewal form has been shortened to collect only your organization data.Click here to complete the application and renewal form online. Or, if you prefer a hard copy to complete the form click here, and mail to WAFCC: 1256 Capitol Dr. Suite 700 #210 Pewaukee, WI 53072
Step 2: Clinic Patient Data Survey
A new Clinic Patient Data Survey has been created to collect data to be used to increase our advocacy and funding efforts on behalf of free and charitable clinics. We understand that you may not have all the data requested but ask that you provide your best estimates. Please complete the survey by the end of January so we can use the data as we begin meeting with legislators in February. Click hereto complete the survey online. Or, if you prefer a hard copy to complete your survey click here and mail to WAFCC at the above address.
Step 3: Membership Fee
Please pay your $100.00 membership fee electronically using the Pay Now button, or mail a check to the above address.