Medicaid & SNAP Assistance Appointments

Chipola Healthy Start Coalition, DCF Community Partner

Plaza del Rio 2944 Penn Ave Suite A Marianna, Florida 32448

Phone: 850-482-1236
READ CAREFULLY: We are a community partner that assists with individuals applying and renewing benefits through DCF. This includes Health Coverage (Medicaid), SNAP (food stamps), TANF (cash assistance) and Optional State Supplementation (OSS).

We are NOT DCF and can not assist with DCF investigations. We also do not determine eligibillity for benefits. If you need to reach someone regarding your eligibilty for benefits or your status, please call MyACCESS Customer Call Center
850-300-4323
M-F: 7am to 6pm
Florida Relay 711 or TTY 1-800-955-8771

For "HOW TO" help videos please visit

https://myaccess.myflfamilies.com/Help/HCVID

This company does not discriminate on the basis of race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law.
Customer's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email
example@example.com
PLEASE SEE BELOW FOR SCHEDULE

Walk-in : Tuesdays 9:00AM-10:30AM or FRIDAYS 8:30AM - 11:00AM

WEDNESDAY & THURSDAYS REQUIRE APPOINTMENTS.

Please call 850-482-1236 to see if there is an opening for a walk-in.

We are closed Monday- Thursday for lunch from 11:00 am -12:00 pm and Fridays at 12:00 noon

If you have more than one person that needs assistance, you must schedule an appointment time for each person by completing another form.
Appointment Request
Do you have a MyACCESS Account?

YesNo
Can you get into your MyACCESS Account?

YesNo
What do you need assistance with?

Apply for Medicaid or Food stampsRenew Medicaid or Food StampsTANF (Cash assistance)Gain access to MyACCESS accountMedicare
Do you have any other comments regarding your benefits?
We do not determine eligibility for benefits.
Please sign the ACCESS Partner View System Release. (If you are unable to, one will be available for you to sign at your appointment.) This is required before any services can be rendered.
STOP! READ THIS BEFORE YOU PROCEED

Before you come in make sure you have what you need. This will keep you from having to reschedule your appointment. Please bring proof of Identification or we cannot assist you with your benefits.

Some commons items that you need are:
1. The email address used to create the My ACCESS Account.
2. The phone number attached to the email used for the MyACCESS account.
PROOF OF INCOME examples:
- 4 weeks of paystubs
- proof of child support
- proof of social security or disability benefits
- proof of retirement
- proof of ALL income
FOR MEDICAID
- Copy of unpaid medical bills
OTHER
- Social security number or card for all applying
I give permission to be contacted by telephone, text or email from a community partner navigator.

Powered by Jotform SignClear
Signature of Customer
Please verify that you are human*
Should be Empty: