Medical Malpractice Insurance Premium Grant

The GBHCW has established a grant to provide medical malpractice insurance premium grants to physicians and dentists that maintain a practice in an underserved rural area of the state. Please find the forms below.

Medical Malpractice Insurance Premium Grant Application

Download this pdf file.Vendor Management Form

Download this pdf file.W-9 Form

Vendor Management Form (sample)

W-9 Form (sample)