|
|
|
Publication Order Form |
|
|
|
|
Please tell us about you:
First Name:
Last Name:
Title,
Parent, or Enrollee as Applicable:
Telephone:
Street
Address:
Street
Address 2:
City:
State:
Zip Code:
E-mail
Address:
|
|
Your
Request
Please
specify the publications you are ordering by indicating the
number requested.
Publication
Title
|
 |
Number
Needed |
|
|
|
|
|
Maryland
Children's Health Program and MCHP Premium
|
|
|
|
|
|
MCHP
Flyer/Programa de salud para los Ninos de Maryland (English on one side, Spanish on
the other)
|
 |
|
|
MCHP Premium Fact Sheet |
 |
|
|
Two
Steps to MCHP (English) - Step by step enrollment information
|
 |
|
|
Medical
Assistance for Families and MCHP
Application (English)
NEW!!! |
 |
|
|
MCHP
School
Health Outreach Materials Kit (for schools - one per school)
|
|
|
|
New Application Requirements (English)
|
 |
|
|
New Application Requirements (Espanol)
|
 |
|
|
|
|
|
|
HealthChoice
|
|
|
|
|
|
HealthChoice
Basics |
 |
|
|
Getting Help with
MCHP and HealthChoice - English, Greek, Korean, Russian,
Spanish, Yiddish, and Vietnamese.
|
 |
|
|
CARE Brochure |
 |
|
|
HealthChoice
Customer Service Contact Information |
 |
|
|
|
|
Local Health Services Request Form (DHMH
Form 4582) |
|
|
|
|
|
|
|
Instructions for Local Health Services
Request Form |
 |
|
|
Local Health Department Use Page |
 |
|
|
MCO Use Page |
 |
|
|
Provider Use Page |
 |
|
|
Brief Instruction and Addresses |
 |
|
|
|
|
|
|
Special
Needs Populations
|
|
|
|
Maternal
and Child Health - Pregnancy/Family
Planning |
|
|
|
|
|
Maternal
and Child Health Programs Brochure
|
 |
|
|
Maryland
Medicaid's Family Planning Program Flyer
|
 |
|
|
Getting
the Most from Your HealthChoice Managed Care Benefits When You
are Pregnant (booklet) |
 |
|
|
Bereavement
Resources and Perinatal Loss Support Groups
|
 |
|
|
|
|
|
|
Adults
with Disabilities |
|
|
|
|
|
Points
of Entry: Maryland Medicaid Waiver Programs for
Adults with Physical and Developmental Disabilities
|
 |
|
|
|
|
|
|
Children
with Special Health Care Needs
|
|
|
|
|
|
Gateways
to Health Care for Children with Special Health Care Needs: A
concise guide to understanding your health plan
and
accessing the care your child needs in Maryland |
 |
|
|
|
|
|
|
Children
with Special Health Care Needs: Getting Help and Information
in the Baltimore Metropolitan Area and Beyond (2006-7 edition booklet - 58 pages)
|
 |
|
|
|
|
|
|
Children
with Special Health Care Needs and Respite Care: Respite Care,
Hospice, Day Care, and Summer Camp
Opportunities
(2006-7 edition booklet - 25 pages) |
 |
|
|
|
|
|
|
Children
and SSI: A How-To Guide for Benefits in Maryland (2007-8
edition booklet - 28 pages) |
 |
|
|
|
|
|
|
Points
of Entry into Maryland Medicaid and Medical Care Programs for
Children with Special Health Care Needs Flyer
|
 |
|
|
|
|
|
|
Rare
and Expensive Case Management Program Brief Facts Flyer
(includes a diagnosis listing)
|
 |
|
|
|
|
|
|
Resources for the Uninsured |
|
|
|
|
|
Consumer
Guide to Low Cost and No Cost
Health
Care in Baltimore City (2007-2008 Edition)
|
 |
|
|
|
|
|
|
En Espanól
|
|
|
|
|
|
MCHP
Flyer/Programa de salud para los Ninos de Maryland (English on one side, Spanish on
the other)
|
 |
|
|
|
|
|
|
Solicitudes
en Espanol de MCHP - MCHP Application
|
 |
|
|
|
|
|
|
Dos Pasos a MCHP - Two Steps to MCHP
|
 |
|
|
|
|
|
|
Programa
De Planificación Familiar
De Medicaid En Maryland
-Maryland's Family Planning Program
|
 |
|
|
|
|
|
|
Aprovechando
Al Máximo Los Servicios De Salud De HealthChoice De Maryland
Durante Su Embarazo -
Getting
the Most from Your HealthChoice Managed Care Benefits When You
are Pregnant |
 |
|
|
|
|
|
|
Estoy
Embarazada Y Vivo En La Ciudad De Baltimore ¿Dónde Busco
Ayuda? – I am Pregnant and Live in Baltimore City – Where
Can I Go for Help?
|
 |
|
|
|
|
|
|
Señora,
Cuando Vaya Al Hospital – Things to Remember When You Go to
the Hospital
|
 |
|
|
|
|
|
|
La
Sífilis- Una
Enfermedad Peligrosa Pero Curable – Syphilis – A Dangerous
Disease But Curable
|
 |
|
|
|
|
|
|
Baltimore
HealthCare Access Programa de Servicios y Recursos para la
Comunidad Hispana – Calendario de Actividades - Baltimore
HealthCare Access Immigrant Resources and Services Program
Outreach Schedule
|
 |
|
|
|
|
|
|
Guia de Recursos y Servicios de Salud a
Bajo Costo o Gratuitos en la Ciudad de Baltimore |
 |
|
|
|
|
|
|
En français |
|
|
|
|
|
Programme de Ressources et Services
pour la Communauté Immigrant - Horaires des Activités |
 |
|
|
|
|
|
|
BHCA Directory of Services
|
 |
|
|
|
|
|
|
Other
specify:
|
|
|
|
|
|
|
|
|
|
|
This
symbol indicates a document in Adobe Acrobat PDF format. These-
documents were created in version 8.0. For best results use
version 7.0 or above when downloading these files. To
download a free reader click below. 
|
|
|
|
     |
|
|
Your comments,
questions, and concerns are welcome.
Click here for our Grievance Policy.
Therese
McIntyre
Website
Development |
For questions
about our publications or an order you have previously
placed
call 410-649-0521.
TTY: 410-649-1226
or e-mail us
|
Click
here to e-mail or write us at: Baltimore
HealthCare Access 201
East Baltimore Suite, Suite
1000 Baltimore,
Maryland 21202 |
|
|
Technical
Problems/Site Suggestions, send email to: webmaster@bhca.org
2004
Baltimore HealthCare Access (BHCA) Updated
07/01/08
 |