Fill in the recipient and your address; for bills, include an account number; sign it; keep proof of payment. Instructions for Completing Money Order Inquiry Form.Write the name of where the money order is going. Money orders should be made payable to State Health Department. Medicare may pay you directly when you complete this form and attach an itemized bill from your doctor or supplier. All forms are fillable and ready for download and printing. A POLST is a physician-signed order form which communicates and puts into action treatment preferences when a patient is near the end of their life. Attorneys and claims agents are available to assist you in completing your application. There is no enrollment required for MbM. To begin using MbM, fill out the MbM Prescription.