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Get CT W-1F 2012-2024

YOU HAVE ANY QUESTIONS, PLEASE CALL YOUR ELIGIBILITY WORKER, . AT , To Home Care applicants: You must call our Alternate Care Unit at 1-800-445-5394 to be screened for Home Care Services before completing this application. If you appear to be eligible, we will also process this form as an application for Medicaid. THIS INFORMATION IS AVAILABLE IN ALTERNATE FORMATS. PHONE (800) 842-1508 OR TDD/TTY (800) 842-4524. (See Reverse Side for Information about Required Proofs and Processing Time Limits.

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