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Applications

Public Assistance Applications

Food Support, Cash, Housing Support or Emergency Assistance
Combined Application Form (DHS-5223)

Health Care
MNsure Application for Health Coverage and Help Paying Costs DHS-6696

If you are 65 or Older or are Blind or have a Disability
MHCP Application for Certain Populations DHS-3876

If you are applying for Long Term Care Services
MHCP Application for Payment of Long-Term-Care Services DHS-3531

If you have Breast or Cervical Cancer
MHCP Application and Renewal for Breast and Cervical Cancer Coverage DHS-3525

Child Care
Child Care Assistance Program Application Form DHS 3550

Child Support
Application for Child Support Services DHS 1958

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