Family Planning Only Services Program

What is the Family Planning Only Services Program?

The purpose of this program is to provide contraceptive (birth control) services and related reproductive healthcare that is part of regular birth control services to eligible women. See eligibility requirements below.

Who should Consider this Program?

Wisconsin women seeking contraception are now able to get confidential family planning health care services and supplies through the Family Planning Only Services Program.

Goal of Family Planning Only Services Program

Help women reduce unintended pregnancy and obtain family planning health care services.

What Services Can I Receive?

• Contraceptive services and supplies
• Pap tests
• Tests and treatment for Sexually Transmitted Diseases (STD) and other select lab tests
• Annual and routine preventative primary care services

Who Can I See?

Any one of our highly qualified providers here at the SHC! No need to find a new provider and go elsewhere.

Who Can Get These Services? (Eligibility Requirements)

Use the checklist below to see if you might qualify: 
I am a female at least 15 years old. Yes  No  
I am a U.S. citizen living in Wisconsin. Yes  No
I have income at or below $3,253.79 per month. Yes  No 
I do NOT receive Wisconsin Medicaid, Badger Care, or Healthy Start. Yes  No 
I meet the following income requirements: Yes  No 

If you answered "yes" to all of the statements above, there is a good chance you qualify for the Family Planning Only Services Program.

THE STATE OF WI IS REQUESTING THAT ALL NEW AND RE-APPLICATIONS FOR THE FAMILY PLANNING ONLY SERVICES PROGRAM BE CONDUCTED ONLINE

To apply online, you will need the following items:

• Computer with internet access
• Access to a printer
• Copy of picture ID (e.g. driver's license or school ID)
• Copy of birth certificate or passport (only if you were NOT born in the state of WI)
• Income verification (copy of paystubs for the 30 days prior to application OR statement from your employer indicating start date, number of hours worked per week, and rate of pay or salary to be signed by a supervisor or manager)

How To Request an Official Copy of Your Birth Certificate
Visit the National Center for Health Statistics to learn how to request an official copy of your birth certificate from the state in which you were born. It may take 4 to 6 weeks to receive your birth certificate.

**Please be aware if for ANY reason your Family Planning Only Services Program application is denied, you will be financially responsible for services or supplies rendered during family planning visits.**

• Apply online at www.access.wisconsin.gov - click on "Apply for Benefits"
• You will be required to create a Wisconsin User ID and password to access your account.
• Provide the necessary information as required by the application.
• Upon completing your application you will be able to print a copy--click on the link "Print my application" to do this. NOTE: To receive services covered under the Family Planning Only Services Program at the Student Health Center you MUST bring a copy of the first page of your application which includes your ten-digit tracking number.
• IMMEDIATELY mail or fax supporting documentation (picture ID, birth certificate/passport, paystubs-include Social Security number and ten-digit tracking number on these documents) to Enrollment Services to expedite the processing of your application.

CDPU                                                                                 Fax # 
P.O. Box 5234                                           OR                        1-855-293-1822 (toll free) 
Janesville, WI 53547