Informational Materials

Eligibility Screening

• WHP Screening Tool (English)
• WHP Screening Tool (Español)
  
• WHP Income Worksheet
  
• WHP Checklist for Appointment Staff (What an Applicant Should Bring to her Appointment)

Application and Forms

• WHP Application (English)
• WHP Application (Español)
  
• Order Form for WHP Applications
• Report of Change (English)
• Report of Change (Español)

Information and Referral

• 2-1-1 Flyer

Outreach

• Post-Application Flyer (English)
• Post-Application Flyer (Espanol)
• PDF of WHP Brochure (English)
• PDF of WHP Brochure (Español)
  
• Client Information Flyer (Text-only version of the Women’s Health Program brochure)
  
• Alternative Client Information Flyer (for providers that do not offer contraception) (English/Español)
  

Benefits

• Allowable Diagnosis and Procedure Codes
• Prescription Drugs Available through Pharmacies
• DSHS & WHP Comparison Chart