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View and Print New York City Health and Human Service Program Application Forms

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Form List
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Click on the links below to view and then print the forms.
If you need help in completing these application(s), please contact the Agency.

Programs for Families with Children

Child Care Application View and printView and print     
Child Care Application Instructions View and printView and print     
Out-of-School Time (OST) Application View and printView and print     

Employment and Training Programs

NYCHA Resident Economic Empowerment and Sustainability (REES) Customer Information Form View and printView and print     
Senior Employment Services (SES) Form View and printView and print     
Workforce1 Customer Information Form View and printView and print     

Food and Nutrition Programs

Supplemental Nutrition Assistance Program (SNAP) Application View and printView and print     
Supplemental Nutrition Assistance Program (SNAP) Application Instructions View and printView and print     
WIC Medical Referral Form for Infants and Children View and printView and print     
WIC Medical Referral Form for Pregnant/Breastfeeding/Postpartum Women View and printView and print     

Health Care Services

Nurse-Family Partnership Referral Form for first time pregnant women View and printView and print     

Health Insurance Programs

Family Planning Benefit Program (FPBP) Application View and printView and print     
Family Planning Benefit Program (FPBP) Instructions View and printView and print     
Public Health Insurance Application View and printView and print    NOTE: For individuals aged 65 or older or seeking long-term care
Public Health Insurance Application Instructions View and printView and print     
Public Health Insurance Supplement A View and printView and print    NOTE: This supplement is also required for anyone applying who is age 65 or older, blind or disabled, or seeking long term care

Housing Programs

Disability Rent Increase Exemption (DRIE) Application View and printView and print     
Exemption Application for Owners (For DHE, SCHE, STAR, and Veterans' Exemption) View and printView and print     
Senior Citizen Rent Increase Exemption (SCRIE) Application View and printView and print     
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