Forms & Applications Consumer Applications To apply for health and human services see the consumer section of this website. Individuals and families can apply online, mail in a completed paper application or apply by phone. When applying for any program, accompanying documents are usually required. For information on Katie Becket and how to apply, see Katie Beckett. For information on Medicaid Long-Term Services and Supports (LTSS), see Medicaid LTSS. Application for State Assistance to Pay for Healthcare Coverage Forms Medicaid LTSS Renewal If you are already active on Medicaid, fill out this form in place of the DHS-2 application: LTSS Renewal Form Changes to Medicaid LTSS LTSS Change Report Form Personal Needs Fund: Personal Needs Fund Regulations Personal Needs Fund Authorization Document Exhibit B Exhibit C Access to Public Records Requests (APRA): APRA Information & Guidelines APRA Request Form Long Term Care Forms: Referral for Preventive or Medically Complex Needs (GW-OCP) Request for Level of Care/Cover Sheet (GW-RR) Medical Evaluation of Applicant for Level of Care (GW_OMR-PM-1) Nursing Home Transition Program Referral Form (GW-REF) Home Care Information: Home Care Services Request Form and Instructions (for former RHO Unity members) Electronic Visit Verification (EVV) Info (for former RHO Unity members)