Applications & Forms
Complete Applications Using the Benefit Finder:
A quick and easy way to apply for programs is to use the Benefit Finder. It saves you time by helping you find out now if you're eligible for free or low-cost health coverage and food assistance!
Below you will find supplemental forms that you may be asked to fill out and return when applying for certain benefit programs.
Additional DSHS Forms You May Need:
- Income Verification
- Statement of Shared Living Arrangement – explains how the people who live at your address share expenses. This form is used in applying for food stamp benefits.
- Statement from Landlord / Manager – provides proof of your housing costs
- Change of Circumstance Form – report changes of address, income, expenses, family size, etc.
- DSHS Client Rights and Responsibilities – what you need to know about applying for and receiving benefits from DSHS
Washington Apple Health for Pregnant Teens
There is a new program for pregnant teens to access health care coverage. To be eligible, a pregnant teen must be a Washington State resident under age 19. There is no income limit for the program. Pregnant teens in this program will be treated as an independent household and will not need to provide their parent’s income or financial information.
To apply, please complete the paper application below.
Application for Pregnant Teen Health Care Coverage
MAIL the completed application to:
Medical Eligibility Determination Services
PO Box 45531
Olympia, WA 98504-5531
Please Note: You do NOT apply for pregnant teen coverage on Washington Healthplanfinder. For more information or help applying, call the Apple Health for Kids Hotline toll-free at 1-877-543-7669.
WIC Nutrition Program:
There is no application for WIC.