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How to apply.




To fill out an application from your computer, click here.

To download an application to print, click here. (This form requires the Adobe Acrobat Reader®), or you can call hawk-i Customer Service at 1-800-257-8563 and ask that an application be mailed to you.

Be sure to sign the application.

Please note:  The form should be mailed to:
Imaging Center 4
PO Box 2027
Cedar Rapids, IA 52406

You can also fax the form to : 1-877-457-7701 or 1-515-457-7701.

If you do not have  Adobe Acrobat Reader®, you can download it for free by clicking here.

Call us at 1-800-257-8563, Mon to Fri, 8am to 6pm
TDD:  1-515-457-8051 or 1-888-422-2319

What health plans are offered?How much do I pay?Do my kids qualify?What services can my kids get?How can I keep my kids healthy?How do I apply?