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.

Download this pdf file.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)