Get Form - Dfa-rfa-1 - Request For Assistance - Dhhr - Wvdhhr

Filling out the FORM - DFA-RFA-1 - Request For Assistance is a crucial step for individuals seeking assistance from the West Virginia Department of Health and Human Resources. This guide provides clear, step-by-step instructions on how to successfully complete the form online and ensure that your application is processed efficiently.

Follow the steps to effectively complete the form online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Indicate the benefits you wish to apply for by selecting from the options listed including food stamp benefits, WV WORKS/cash benefits, Medicaid, or emergency assistance.
3. Enter your personal information in the designated fields. Provide your name, address, city, state, zip code, and signature. It is important to note that the date you submit this form, along with your name and signature, marks the date of your application.
4. If you are experiencing homelessness, you are not required to fill in an address.
5. Complete the optional information sections to help the Department assess your eligibility more quickly. This includes questions specifically for food stamp benefits, WV WORKS, Medicaid, and emergency assistance.
6. If applicable, provide details such as your Social Security number, sex, date of birth, and phone number in the optional information for all programs.
7. Once you have filled out all necessary fields, review your entries for accuracy. You can then save your changes, download, print, or share the completed form as needed.

Take the first step towards obtaining assistance by completing your FORM - DFA-RFA-1 - Request For Assistance online today.