Food Assistance and Medicaid

Intake/Redetermination Information


Please review the forms below to see all the information that you will need for your interview:


4059 - Explanation of State Hearing Procedures

7217 - Voter Registration Rights & Declination

7236 - Rights & Responsibilities as a Consumer of Medicaid Health Coverage

7400 - Ohio Medicaid Estate Recovery

8000 - Your Rights

8033 - Program Guide

8058 - Medicare Premium Assistance Program



DOWNLOAD ACROBAT READER TO OPEN THE FORMS ON OUR SITE          - YOU MUST HAVE ADOBE READER INSTALLED TO OPEN THE ABOVE FORMS