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

FCC Form 460

Eligibility and Registration Form

FCC Form 460 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

FCC Form 461

Request for Services Form

FCC Form 461 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

FCC Form 462

Funding Request Form

FCC Form 462 Instructions

FCC Form 462 Best Practices (Individual HCPs)

FCC Form 462 Best Practices (Consortia)

FCC Form 463

File Online

FCC Form 463

Invoice and Request for Disbursement Form

FCC Form 463 Instructions

Click here for service provider forms (FCC Form 498, FCC Form 499-A/499-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.