Applications for Public Assistance

Use the links below to apply.

• Complete a paper Application for Services and send by mail, fax, email, in-person/lobby drop box, direct secure messaging (requires a DSM account), or through a fee agent.
• Contact the Virtual Contact Center 800-478-7778 (TDD/Alaska Relay: 7-1-1) and apply for benefits over the phone
• See our Contact Us page for more information.

Medicaid Applicants please note:

• Income-based Medicaid applicants are encouraged to apply at www.healthcare.gov. This is the fastest way to see if you’re covered.
• Older age or disability Medicaid applicants should only use the following (paper) application at this time:

Other Applications

• Senior Benefits Program: Application
  
• Heating Assistance Program: Application
  One benefit is issued per “season” which runs from October 1 through August 31. Outside those times, visit a local office for an application or ask the Heating Assistance Office at 800-470-3058 or liheap@alaska.gov.
• WIC (Women, Infants and Children) Program:
  Call the WIC clinic closest to you. You can find clinics near your location by entering your zip code on WIC Signup page or by selecting a clinic from our WIC Clinic contact information page.
  Download and complete the paper forms and call the WIC clinic closest to you. Paper forms include:
  
  • Family Information
    Complete one form for the whole family.
  • Pregnant Women Application
    Complete one form for every pregnant woman in the family.
  • Postpartum/Breastfeeding Application Form
    Complete for a woman who has a baby (less than six months old) taking formula or a woman who is breastfeeding a baby (that is less than one year old).
  • Infant Application Form
    Complete one for every infant in the family, age birth to one-year-old.
  • Child Application Form
    Complete one for every child in the family who is one- to five-years-old.
  • Commodity Supplemental Food Program (CSFP) Application
    (CSFP) works to improve the health of seniors at least 60 years of age by supplementing their diets with nutritious USDA commodity foods.
• Child Care Program Office:
• Information for Families
• Service Delivery Areas (map)
• Child Care Assistance Contact Information
  Be sure to scroll down to the contact information that corresponds with the office located on the map.
  
• CC08 - Child Care Assistance Application
• CC24 - Health Status Report
• CC36 - Employment Statement
• CC37 - Family Report of Change
• CC38 - Monthly Tip Ledger
• CC39 - Self-Employment Income / Deduction Worksheet
Provider forms are available at the Child Care Services Forms section of the Child Care Program Office website.