Getting Started

For additional help with Medical Assistance Applications, please call the Health First Colorado Member Contact Center at 1-800-221-3943.

For additional help with requests for Supplemental Nutrition Assistance Program (SNAP) or cash assistance, please call 1-800-536-5298.

For additional help with Child Care Assistance Program (CCAP) applications, contact your local county office.

Note: It is best to fill out as much of the application as you can before submitting it. However, applications for SNAP, Colorado Works, and/or Adult Financial programs may be submitted with only your name, address, and signature. You will be contacted for any additional information that is needed to complete the application.

Information About You

"You" means the person who is applying for benefits. If you're helping someone use this website, please fill out this page as if you were that person.

Name:

  • Please be sure to use your full, legal name.
  • Don't use nicknames on this application.
  • If your name doesn't fit in the boxes, just type as much as you can.
  • If you have two last names, enter both WITHOUT a space or a dash between them. EX:JohnsonSmith

Date of Birth:

  • Be sure to use this format: MM/DD/YYYY.
  • For example, if your birthday is March 12, 1973, type 03/12/1973.

Where You Live

Home Address: Your local application office will use this home address to send letters and other information to you - including the decision about whether or not you can get benefits.

Mailing Address: If you don't want us to send any letters about your benefits to your address you provide in this section, please also give us a mailing address.

If you are homeless or don’t have an address right now:

  • Please check the ‘I am homeless’ box and leave the home address blank.
  • If you have an address we can use to send you letters about your benefits, you should type it in as your mailing address.
  • Leave the home address question blank if you don't have an address right now.


Contact your nearest County Human Services office directly for details on how to apply for child care assistance, if you are homeless or do not have a home address.


County: Select the county where you are currently living, even if you are homeless or going to move soon.

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