Get Print The Application (pdf, New Window) - Arkids First!

This guide aims to assist users in accurately completing the Print The Application (PDF, New Window) - ARKids First! form online. Following these clear, step-by-step instructions will ensure that you provide the necessary information for health coverage assessment.

Follow the steps to fill out the application form accurately:

1. Click ‘Get Form’ button to access the application. This will allow you to obtain the form for completion in a suitable format.
2. Begin with Step 1 by entering your personal information. Include your first name, middle name, last name, and suffix, if applicable. Provide your home address including city, state, and ZIP code, along with your contact information.
3. In Step 2, list all family members who live with you or who you claim on your tax return. Be sure to include yourself, your spouse, children under 21, and any other dependents.
4. Continue detailing each family member's information, repeating the process for each individual, starting with yourself. If your family comprises more than two members, make copies of the relevant pages to include all necessary information.
5. Proceed to Section regarding health coverage. Indicate any existing health insurance coverage and whether anyone in your family is currently enrolled in any program.
6. Once all sections are completed, review your application for accuracy. Ensure that all required signatures are provided, and that the information matches the documentation you will submit.
7. Lastly, save changes, and download your completed application. You may print it out to send via mail, or choose to email or fax the application to the appropriate department.

Take the next step towards health coverage by completing and submitting your application online.