Ronald McDonald House Charities of Bismarck
The House
The caremobile

Contact Us
One House, Many Hearts
Care Mobile
Site Partner Information and Forms

Additional Related Information


Site Partner Brochure
File Size: 1118.06 kb

Information to promote the program in communities and schools.

2023 Care Mobile Schedule
File Size: 141.69 kb

Site Partner Information
File Size: 104.24 kb

A guide to organize a Ronald McDonald Care Mobile visit to your community.

Sample Site Partner Letter of Agreement
File Size: 20.89 kb

A letter of agreement between the site partner and Ronald McDonald House Charities outlining the roles and responsibilities of each party.

Site Partner HIPAA Agreement
File Size: 195.01 kb

This document outlines the site partner requirements in terms of the Health Insurance Portability and Accountability Act.

Site Partner Community Promotion Poster
File Size: 33.38 kb

A poster template to promote the program in the local community.

Parent Information Card
File Size: 134.22 kb

Information about the program and locations.

Program Eligibility Requirements
File Size: 33.62 kb

An information sheet outlining the program eligibility requirements to be seen.

Parent Information Sheet/Sign Up
File Size: 41.37 kb

An information sheet that promotes the program and provides a sign-up form for parents.

Medical/Dental Coverage Options
File Size: 85.89 kb

A sing-up form for parents to determine eligibility for dental program coverage.

Parent Enrollment Letter
File Size: 79.15 kb

Information about the program and the eligibility criteria.

Patient Rights and Responsibilities
File Size: 86.98 kb

Information for parents outlining patient rights and responsibilities.

Notice of Privacy Practices
File Size: 130.31 kb

Parent/patient notice of privacy practices.

Patient Information and Consent Forms
File Size: 159.14 kb

Forms to be completed and signed by parents/guardians, including the child's dental and medical history, insurance information and consent forms.

After the Ronald McDonald Care Mobile Visit
File Size: 165.25 kb

An information sheet on parent and community follow-up after the visit.