HEALTH Program

• Perform basic health screening
• Assist with disability and Medicare/Medicaid applications
• Educate about diseases and medications
• Update prescriptions
• Offer health counseling and coordination of local resources
• Provide basic health supplies
• Coordinate with local primary care providers
• Complete advance medical directives
• Assist with housing applications

PATIENT HANDOUT

PATIENT REFERRAL FORM

PLEASE PRINT OUT AND HAND COMPLETE

Note: Please do not send any patient-specific information over the internet.  We will contact you for further details about patient-specific requests.

We do not do the following:

• Provide prescriptions for narcotic pain medications, amphetamines, benzodiazepines, phenteramine or phosphodiesterase inhibitors 
• Give samples of prescription medications
• Offer ongoing primary care services
• Perform sexually transmitted infection or pregnancy testing

HEALTH Program volunteers work with patients at several community locations.  A dedicated HEALTH Program nurse is available to assist with care coordination once a patient has been enrolled in the HEALTH Program. 

There is no cost to the patient to participate in the HEALTH Program and referrals for assistance of homeless patients are accepted from any location in Dane County.