Member Forms

Application Forms

If you want to fill out a paper application and mail it in, print out one of the applications below. You can also drop it off at your county of residence's local county office or at a local application assistance site.

Apply Only for Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+)

• Health First Colorado, Child Health Plan Plus (CHP+) Paper Application - English
• Health First Colorado, Child Health Plan Plus (CHP+) Paper Application - Spanish

Apply for Health First Colorado, Child Health Plan Plus (CHP+), Cash, and Food Assistance

• Health First Colorado, Child Health Plan Plus (CHP+), Cash, and Food Assistance Paper Application - English (or Large Print Version)
• Health First Colorado, Child Health Plan Plus (CHP+), Cash, and Food Assistance Paper Application - Spanish (or Large Print Version)

Disability Applications

If you believe you have a disability, even if you have been denied disability status by the Social Security Administration, please also fill out the Disability Application:

• English Disability Application (or Large Print Version)
• Spanish Disability Application (or Large Print Version)

Establish Identity

Use the forms at the links below to establish identity if:

• your application includes a child age 0-15 who does not have acceptable identity documents (acceptable documents include clinic, doctor, hospital, or school records) 
  or
• your application includes an individual age 16-18 who does not have acceptable identity documents (acceptable documents include school identification cards, state ID or drivers' licenses) 
  or
• your application includes an individual with a disability in an institutional care facility and no other evidence of identity is available.
  • English Affidavit to Establish Identity Form
  • Spanish Affidavit to Establish Identity Form

Out of State Former Foster Care Medical Assistance

If you received Former Foster Care Medical Assistance out of state and are applying alone, do not use the full medical assistance application. Fill out the form below.

If you are applying for yourself and other members of your household, include the form below with the full medical assistance application. 

Please complete the form below for medical assistance if all of the following apply to you:

• You are 18 to 25 years old, and
• You are now a Colorado resident, and
• You were not adopted out of Foster Care, and
• You received Former Foster Care Medical Assistance out of state, and
• You turned 18 on or after January 1, 2023.
  • English Health First Colorado Out of State Former Foster Care Youth Form
  • Spanish Health First Colorado Out of State Former Foster Care Youth Form

Paperwork for Applicants and Members

This page contains copies of some of the paperwork you will receive when you apply for or renew health coverage. These forms are here for your convenience if you misplace your original form or need a copy.

• Health Coverage Additional Information Form - English
• Live-In Home Care Provider Statement - English
• Live-In Home Care Provider Statement - Spanish
• Medical Assistance Additional Information Form - English
• Medical Assistance Additional Information Form - Spanish
• Rental Property Verification Form - English
• Rental Property Verification Form - Spanish
• Tax Information Packet - English
• Tax Information Packet - Spanish