Rural Health Care
About Rural Health Care:
- Overview of the Program
- Overview of the Process
- Monthly Conference Calls
- Site Visits
- Understanding Audits
- Filing Appeals
- Rural Health Care Pilot Program
Rural Health Care Tools:
Prior Year Forms
The forms may be revised each funding year. Applicants must use the correct funding year form to participate.
Applicants are encouraged, if possible, to e-cert and submit their forms electronically.
Fund Year 2007
| FY
2007 Form 465 Description of Services Requested & Certification Form |
Apply Online or Download only: View instructions Download: |
| FY
2007 Form 466 Funding Request & Certification Form |
Apply Online or Download only: View instructions Download: |
| FY
2007 Form 466-A Internet Service Funding Request & Certification Form |
Apply Online or Download only: View instructions Download: |
| FY
2007 Form 467 Connection Certification Form |
Apply Online or Download only: View instructions Download: |
Fund Year 2006
| FY
2006 Form 467 Description of Services Requested & Certification Form |
Apply Online or Download only: View instructions Download: |
Fund Year 2005
| FY
2005 Form 467 Connection Certification |
Apply Online or Download: View Instructions Download: |
Fund Year 2004
| FY
2004 Form 467 Connection Confication |
Apply Online or Download only: Download: |
