Resources

Forms

View, Download, or Print These Forms: 1138 Application for Child Care Benefits 3528 HealthChek 6723 Authorized Representative Form 7200 Apply For Cash, Food, and Medical Assistance 7204 Request to Reapply for Cash and Food Assistance 7216 Application For Health Coverage Only (Medicaid) 7400 Estate Recovery Information 7501 Program Enrollment & Benefit Information Voter Registration and

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Help

COMMON QUESTIONS What should I know about applying for medical coverage and food stamps? The 7501 Program Enrollment & Benefit Information form is a great resource to help you learn more about these programs.  You can also browse this site and the state website at jfs.ohio.gov for more information about all of our services. What is Estate Recovery? "If...

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Report Child or Adult Abuse

Use this form to report a situation that you feel should be brought to our attention.  CALL 911 for an emergency situation. Your Name (The agency will not give your name to the person suspected of abusing the child.) Your Phone Number Your Email DETAILS: Short Summary Of Issue (required) Name of Offender(s) You Are...

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Report Welfare Fraud

Use this form to report a situation that you feel should be brought to our attention. CALL 911 for an emergency situation. Your Name Your Phone Number Your Email DETAILS: Short Summary Of Issue (required) Name(s) You Are Reporting (required) Address You Are Reporting (required) Details About Issue You Are Reporting Answer this question in...

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