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Forms & Other Information

Public Assistance Forms

  • JFS 01138 Child Care Application (PDF)
  • JFS 02399 Request for Medicaid Home & Community Based Services (PDF)
  • JFS 04221 Eligibility to Take Food Home Form (PDF)
  • Food Programs Fact Sheet (PDF)
  • ODODM 07161 OH Breast & Cancer Medicaid Application (PDF)
  • JFS 07200 Application for Benefits Application for Benefits (PDF)
  • JFS 07501 Program Enrollment & Benefit Information (PDF)
  • Expanded OH Medicaid General Information
  • ODM 7216 Application for Health Coverage& Help Paying Costs (PDF)
  • JFS 01643 Provider Type B Application/Certification (PDF)
  • Federal Poverty Guidelines FPG
  • How to Apply for Medicaid – Nursing Home
  • On-Line Benefits Application
  • PRC Application (PDF)
  • PRC Federal Poverty Level Guidelines

Child Support Forms

  • Child Support JFS7076 IV-D Application for Services (PDF)
  • Child Support Rights-Responsibilities JFS 07012 (PDF)
  • Child Support Explanation of State Hearing Procedures (PDF)
  • Child Support JFS01849 Review & Adjustment Request Form (PDF)
  • Power Of Attorney Form (PDF)

Children & Elderly Services Forms

  • JFS 01675 – Ohio Adoption Guide: A Handbook for Prospective
  • Federal Poverty Guidelines FPG
  1. Children & Elderly Services
    1. Adoption
    2. Child Abuse & Neglect
    3. Elder Abuse & Neglect
    4. Foster Care
  2. Child Support Enforcement Agency
    1. Case and Payment Information
    2. Employer Resource
    3. Enforcement
    4. Modification
    5. Paternity Establishment
    6. Support Establishment
  3. Forms & Other Information
  4. Fraud Reporting
  5. Job Services
  6. Public Assistance
    1. Cash Assistance
    2. Child Care
    3. Food Assistance
    4. Medical
    5. Prevention, Retention & Contingency (PRC)
    6. Transportation
  7. Re-Entry Connection
  8. Legal Notices & RFP
  9. Family Resource Guide
  10. Apartment Listings
  11. Road to Wellness Event
  12. Fulton County Housing Coalition
Employment
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Covid-19
  1. Home
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  1. Fulton County Government Main Site
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  1. Government Websites by CivicPlus®
  1. Transparency In Coverage Machine Readable File USE EIN #33-1074275 for login.
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  1. Fulton County Ohio

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