109 APPLICATION PROCESS SR 94-50, Dated 09/94 (FAM-A)

Any individual has the right to apply for assistance and to have an eligibility decision made on the application. Application is made on Form 800, Application.

An individual may request an application by contacting any District Office. Give Form 800, Application, to anyone requesting it. If the individual contacts the District Office by telephone or mail and does not want to come to the office to file an application on the same day, mail a Form 800 to the individual on the same day the request is received.

Households may apply for Medical Assistance for Poverty Level Pregnant Women and Poverty Level Children’s Programs at participating local health facilities. Contract agency clinics funded by the Department of Public Health Services will provide and accept Form 800P, Application for Medical Assistance for Low Income Pregnant Women and Children on site.