A variety of online and paper forms are available to applicants, recipients and sponsors.  For help in applying for Medicaid, contact 1-800-362-1504.
 
                
                Request for Covered Services
                
                    
                        
                            
                            
                        
                        
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                            | Form | Form for Dossier process used by providers to submit evidence related to the effectiveness and safety of a service under review for coverage by the Agency |