Benefits Assistance Referrals

If your agency encounters a person in need of application assistance for state benefits: SNAP (formerly food stamps), TANF, Medicaid/CHIP, Medicare Savings program, etc., refer them to our Benefits Assistance Coordinator (with their permission, of course)! This is just another way for your agency to better serve the community.

You can refer a client here through the submission box below with the following collected information:

1. Name(s) of the client(s).
2. Client’s contact information (phone number or email address).
3. What programs the client is interested in (if known).

* If you are referring more than one client then please click on the add more clients tab.

Once the referral is made the Benefits Assistance Coordinator will then contact the client you have referred within 3-5 days.

What services would you like to apply for?
SNAP (Supplemental Nutrition Assistance Program)
Medicaid
Medicare
CHIP - Children's Health Insurance Program
QMB - Qualified Medicare Beneficiary
TANF - Temporary Assistance for Needy Families
Other
Do you need help connecting to local resources? Select all that apply.
Employment Assistance
Utility Assistance
Housing and Rental Assistance
Child Care Services
Education Services
Maternity Needs
Veterans Assistance
Domestic Violence Assistance
Transportation
Other

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