Below you'll find organizations that can help you apply, forms that can help you complete an application and report changes down the road, other helpful documents, and a video tutorial to help you apply online. Click here to learn about all benefits available from DCF.
Organizations That Can Help
If you have questions or need help applying, you can call our Benefits Service Center at 1-800-479-6151. In addition, you can also:
Forms To Help You Complete the Application Process
Form 120 - 3SquaresVT & Long Term Care Medicaid Out-of-Pocket Medical Expenses
Form 137 - Child & Medical Support Authorization/ Application for OCS Services
Form 139AP - Alternate Payee Permission Form
Form 139AR - Alternate Reporter Request
Form 139REP - Authorized Representative Form
Forms To Help You Report Changes
Form 200 - Change Report
Form 202H - Shelter Expense Statement
Form 204B - Business Income and Expenses Sole Proprietorship
Form 216 - Financial Aid Information Release
Form 218E - Employment Information
Form 218ET - End of Employment Verification
Other Helpful Documents
Your Rights and Responsibilities
Important Information About 3SquaresVT
Required Documentation
Video Tutorial for Those Applying Online
This video on YouTube guides you through the online application