Please complete the forms below and bring them with you.

Please complete the forms below and bring them with you.

Baldwin Family Health Care is designated as a Federally Qualified Health Center (FQHC). An FQHC receives additional funding from the federal government to extend medical care to communities and individuals who are in an area where access to health care is needed. One requirement of this designation is for the health center to gather additional information about all of our patients to help determine if community medical needs are being met. In order for us to continue to serve our community, we request that you please take a moment to complete the following information.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Family Health Care (FHC) is required by law to maintain the privacy of individually identifiable patient health information (this information is “protected health information” and is referred to herein as “PHI”). We are also required to provide patients with a Notice of Privacy Practices regarding PHI. We are required to post this Notice in a prominent place within our facility. We will only use or disclose your PHI as permitted or required by applicable state law. This Notice applies to your PHI in our possession including the medical records generated by us.
FHC understands that your health information is highly personal, and we are committed to safeguarding your privacy. Please read this Notice of Privacy Practices thoroughly. It describes how we will use and disclose your PHI. This Notice applies to the delivery of health care by FHC.

The Notice of Privacy Practices describes how the Facility uses and discloses your health information and the circumstances under which we must seek your written permission to do so. The Notice of Privacy Practices also describes rights you have under federal regulations called the Health Insurance Portability and Accountability Act (“HIPAA”). HIPAA requires us to provide you with the Facility’s Notice of Privacy Practices and to obtain your written acknowledgment for receiving it.
By signing this form, you are acknowledging that the Facility provided you with its Notice of Privacy Practices; by signing, you are not agreeing or disagreeing with its content. If you do disagree, the Notice of Privacy Practices provides information about how you may address your concerns. By signing below, I acknowledge receiving the Facility’s Notice of Privacy Practices.

TEMPORARY DELEGATION OF POWER BY PARENT/GUARDIAN & LIMITED POWER OF ATTORNEY FOR CONSENT TO MEDICAL TREATMENT OF CHILD/LEGALLY INCAPACITATED PERSON
Parents/Guardians: Don’t leave your loved ones unprotected. Give your permission to a responsible adult so that Family Health Care/Great Lakes Family Care staff can treat your loved ones in the event of an unexpected nonemergent situation if you are going to be temporarily separated from your child or another person for whom you are responsible (parent, grandparent, etc.). Except in emergent situations, Family Health Care/Great Lakes Family Care personnel cannot provide unexpected nonemergent treatment for your child or legally incapacitated person in the event he or she becomes ill or injured without authorization. Your loved one’s care could be needlessly delayed while our staff attempts to contact you. With the proper consent, you assure your loved ones of immediate care should it be necessary. Fill out this limited power of attorney form and leave it with whoever will be responsible for your loved one in your absence. You are encouraged to follow the same procedure whenever you will be away from your loved one.

The portal is a secure, confidential website that gives patients and their families 24-hour access to their medical records using the latest encryption technology to deliver secure communication between patients and providers. By enrolling in our Patient Portal, you will receive notices to your personal email account when there is important information awaiting you in your Patient Portal account. Your name and email address will be treated with the same care and privacy given to your medical records. To speak with one of our staff or to get your Patient Portal enrollment started, please contact your local Family Health Care office.

If you are interested in signing up for our new and improved patient portal contact your providers office.

New Patient Portal

NextMD Patient Portal Login

How to Export Your NextMD Messages

Our mission is to ensure that all patients and community members have 100% access to health care. To help make this possible we have created a sliding scale, which allows us to adjust visit costs depending on the patient’s eligibility for the program. Sliding fee eligibility is based on income and family size.

To apply for the sliding scale, contact one of our Financial Counselors and gather the following information for your appointment:

• Most Recent Tax Return (Used to verify income and household size – Schedule C Form is required for those who are self-employed.
• If you don’t file tax returns then proof of Income for a one-month period (Paystubs, SSI, Disability, DHS Eligibility Statement, Unemployment, Pension, Child support, etc.)

Baldwin – (231) 745-5045
Cadillac – (231) 876-6520
Grant – (231) 834-9717
White Cloud – (231) 689-7676

Family Health Care accepts most insurances including Medicaid and Medicare. Please call one of our offices to find out if we accept your insurance. Even if we do not accept your insurance, Family Health Care has programs available to make health care affordable to you.

Most Popular accepted insurances:
Not sure we accept your insurance? Give us a call!

Did you know you can now pay your statement online through the patient portal? Sign Up Today or Login.

Medical Billing Questions (231) 876-6781
Dental Billing Questions (231) 745-5034 or (231) 876-6526

Requests for Information and Complaints:
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. You may file a complaint by mailing or faxing us a written description of your complaint or by telling us about your complaint in person or over the telephone:

If you are sending a complaint, please describe what happened and give us the dates and names of anyone involved. Please also let us know how to contact you so that we can respond to your complaint. You will not be penalized for filing a complaint.