On your first visit, plan to spend the first 15 minutes completing registration forms. Or complete the forms prior to your visit. They are provided here for your convenience. Print them out and bring them with you.

• Medical History
• Authorization For Disclosure
• 2011 Discount Program (Bring proof of income with you)
• Notice of Privacy Practices
• Patient Agreement for Disclosure of PHI to Family Friends and others form

What To Bring

Please bring these items with you for your first visit:

1. Completed forms (see above)
2. State Authorized Photo ID
3. Social Security Card
4. Insurance Provider Card
5. A list (or the bottles) of all your prescriptions

Common Questions

Click on the link for answers regarding common questions asked about MO HealthNet.
Mo HealthNet FAQ June 2011

In the meantime, if you have a question, please contact us.

Northwest Health Services serves all patients whether insured or not. Costs are based on household size and income. To see if you qualify, complete the simple application and bring it to your first visit along with proof of income.

MHIP

MHIP is for people with pre-existing conditions that can’t get insurance elsewhere. While the premiums are still too high for many people $137-$601 (depending on the consumer’s age and which deductible is chosen).

• To be eligible for MHIP, applicants must be Missouri residents, have a pre-existing medical condition and be uninsured for at least six months.
• Take a look at the application at this link Download the MHIP Application. The application is 9 pages long, BUT it looks very user friendly.