Common application forms

Commonly used application forms and application information for human services programs are listed below. All program application forms can be found in eDocs. Many application forms are published in languages other than English and can be found through eDocs.

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Online applications for individuals and families
- Use MNbenefits to apply online for cash assistance, food benefits, emergency help and child care assistance or help paying for long-term care in a facility, such as a nursing home.
- Use MNsure, Minnesota's health insurance marketplace, to apply online for other health care coverage. Depending on the type of coverage you need, you may not be able to use MNsure. Call your county office to find out how best to apply.
Paper applications for individuals and families
- Use the Child Care Assistance Program Application (PDF) to apply to get help for your child care expenses so you can work, look for work or attend school.
- Child support application information can help parents decide which child support services to apply for so that they can establish a financial partnership so children receive the financial, medical and child care support they deserve.
- Families and individuals who need help to meet their basic needs until they can support themselves use the Combined Application Form (PDF) to apply for Supplemental Nutrition Assistance Program (SNAP) and cash assistance programs.
- Individuals living with HIV/AIDS can use the HIV/AIDS Programs Application (PDF) to apply for life-extending medication therapy and health care.
- Use the Long-Term Care and Waiver Services Application (PDF) to apply for health care coverage for long-term care or services to help you stay in your home.
- Women who have breast or cervical cancer and were screened by the Sage Screening Program use the Medical Assistance for Breast or Cervical Cancer application (PDF) to apply for coverage.
- Families with children and pregnant women can use Minnesota Family Investment Program application information to apply for a monthly benefit that includes cash and food assistance. Parents also get help to find and keep a job. Parents can apply for the Diversionary Work Program to help them quickly find work so that they do not need to go on the Minnesota Family Investment Program (MFIP).
- Men and women between the ages of 15 and 50 who are not enrolled in Medical Assistance or MinnesotaCare use the Minnesota Family Planning Program Application (PDF) to apply for coverage for family planning services.
- Minnesota Health Care Programs application information helps individuals apply for Medical Assistance (MA), MinnesotaCare, and home and community-based waiver programs.
- Supplemental Nutrition Assistance Program (SNAP) application information helps individuals and families with low incomes get the food benefits they need for nutritious and well-balanced meals.
- If you have a hearing loss, speech disability or physical disability that limits your use of a standard telephone, use the Telephone Equipment Distribution Program Application (PDF) to apply for the Telephone Equipment Distribution Program.
Providers
- Human services provider license application forms are available for applicants seeking to provide adult day care, adult foster care, child care and child foster care and other state-licensed services.
- Minnesota Health Care Programs (MHCP) provider enrollment application information is available for individual (e.g., physical therapist) or group (e.g., hospital) health care providers to enroll so they receive payment for serving MHCP recipients.
Employees