Welcome to Health Partnership Clinic! We want to be your home for medical, dental and behavioral health care. We do everything we can to help you get the care you need when you need it – whether you are insured or not.

To become a patient, please follow these steps:

  1. Schedule an appointment – three options:
  1. Complete the forms below and bring them with you.
  2. Your initial appointment will be with our Patient Financial Aid Coordinator. Once your appointment with the Financial Aid Coordinator is complete, she will schedule an appointment for you to be seen by a medical provider.
  3. Bring with you:
  • Getting Started Insurance card
  • Photo ID
  • Proof of address
  • If not insured, documents showing the last 30 days of household income.
    • Two most recent paystubs to equal 30 days
    • Most recent annual federal income tax return
    • Documentation of government assistance:
      • Unemployment compensation
      • SRS cash assistance
      • Social Security or SSI
    • Disability determination with benefit amount
    • Documentation of child support/alimony
    • Letter on employer letterhead, signed and dated by supervisor
    • Financial award letter showing grants, scholarships, fellowships, or assistantships (Loans are not considered as income)
    • Self-Employed: Submit detail of the most recent three months of income and expenses for the business.

Getting Started Adequate information must be made available to determine eligibility. Please submit a notarized letter from the individual assisting you financially and include the monthly monetary amount provided. In addition, we are unable to accept W-2s.

Review Before Your First Visit:

Notice of Privacy Practices
Notificacion de Practicas de Privacidad

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

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Patient Forms 

At HPC we are rolling out a new and easier way to complete forms! In addition to paper copies available in our offices and digital copies that you can print and bring in on your first visit we are now working with Hellosign to help you securely complete the paperwork online!

You will see there are links to the online-fillable versions of these forms. To get started you will need a web browser (like you’re already using!) and an email address. After following the link you’ll be taken to Hellosign’s website where you will be prompted to enter an email address. The email address you enter will receive an email (check your spam or junk folder if you don’t see it!), and you can use the link in the email to begin completing the form.

Once you’re finished you’ll receive another link to view your completed form. When you arrive for your first visit the forms will be printed for you to sign and any additional documents needed (ID, insurance card, etc.) will be collected at that time.

If you’re not comfortable completing these forms online that’s fine too! We still offer the ability to download the forms so you can print them off at your convenience, and also offer paper copies in our offices.

Complete and Return the forms below either via Hellosign or PDF on or before your first visit.

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Outreach-Based Patients (School/Community)

Getting Started Complete and Return Before Your Child’s First Outreach Visit:

Insurance + Other Services
We can help you apply for a Health Insurance Marketplace plan or for Medicaid/KanCare. And we can help you apply for our Sliding Fee Discount.

Patient Portal 

Payment Options