Resources

Descriptions and Applications

Get a head start on the financial assistance process here.

Get descriptions and applications for the most common Social and Rehabilitation Services programs. Applications for Via Christi programs are available as well.

All applications can be printed from this site and should be returned to:

Via Christi Regional Medical
929 N St.Francis
Wichita, KS 67214
Attn: Financial Counseling

Kansas Temporary Assistance for Families

SRS short-term assistance program with medical, food stamps and cash assistance. Use the 3100 form to apply.

Kansas Medicaid for the Disabled

SRS program for the disabled offering medical coverage and sometimes cash and food stamp assistance. Use the 3100 form to apply.

Kansas Sobra

SRS program offering medical coverage for non U.S. citizens. Use the 3100 form to apply.

Kansas Medicaid

SRS program offering medical coverage for disabled adults and families. Use the 3100 form to apply.

Kansas Medicaid for Pregnant Women

SRS program offering medical coverage for low- income families with children aged 1-19 years old. May sometimes offer food stamps and cash assistance. Use the 3100 form to apply.

Kansas Victim of Crime

SRS program that pays some medical expenses for crime victimes cooperating with local district attorney. Use Kansas Crime Victims Application to apply.

Via Christi Financial Assistance

Full or partial assistance from Via Christi. Use the Financial Assistance Application to apply.

Via Christi Medcharge Application

Revolving credit account through Intrust bank. Use the Medcharge Application to apply.