Rural Health Care Program Home

Forms

All HCF Program forms and supporting documentation must be submitted by filing online through My Portal.

FCC Form 460

File Online

Eligibility and Registration Form

FCC Form 460 and Instructions

FCC Form 460 Online Filing Instructions

Community Mental Health Center Checklist

FCC Form 460 Best Practices (Individual HCPs)

FCC Form 460 Best Practices (Consortia)

FCC Form 461

File Online

Request for Services Form

FCC Form 461 and Instructions

FCC Form 461 Online Filing Instructions for Individual HCPs

FCC Form 461 Online Filing Instructions for Consortia

FCC Form 461 Best Practices (Individual HCPs)

FCC Form 461 Best Practices (Consortia)

FCC Form 462

File Online

Funding Request Form

FCC Form 462 and Instructions

FCC Form 462 Best Practices (Individual HCPs)

FCC Form 462 Best Practices (Consortia)

FCC Form 463

File Online

Invoice and Request for Disbursement Form

FCC Form 463 and Instructions

FCC Form 463 Service Provider Guide

Click here for Service Provider and Contributor forms (FCC Forms 498, 499-A/Q)

Applicants without adequate Internet access to submit the forms online should contact the RHC Help Desk via email or at (800) 453-1546 to make alternative arrangements.