Applications for family, children, and pregnant women needing medical assistance only 

• English Application  
• Spanish Application

Applications for people who are 64 years of age or younger and have not been determined disabled by the Social Security Administration needing medical assistance only

• English Application   

• Spanish Application

• English Disability Application 

• Spanish Disability Application 

• Release Form  

Applications for people 65 years of age or older or people have been determined disabled by the Social Security Administration needing medical assistance only

• English Application

• Spanish Application

Where to apply

• County Department of Human/Social Services (for any program) 
• MA Sites  (for medical programs only)

For assistance with filling out the application for assistance, click on the link below to find the nearest Application Assistance Site:

• Application Assistance Sites (for family and children's programs only)

Immunization (shots) Registry Notice

PLEASE NOTE:  The following refers to questions about Immunizations/CIIS only. If you have general Medicaid, eligibility or application questions, you should contact the Customer Contact Center at (303) 866-3513 (Denver Metro area) or (800) 221-3943 (outside Denver Metro area) or email customer.service@hcpf.state.co.us.

Colorado has an immunization registry, a central place for health care providers to keep track of immunizations.  This helps providers know what shots you/your child have had and which ones are still needed. The information in the registry is completely confidential.

Under Colorado law, you can choose to opt out of participating in the registry.  If you opt out, you/your child's immunization history will not be in the registry, and you will need to keep track of this information. You can decide to opt out of the registry at any time.  For more information and an opt-out form, click here. 

For questions regarding Immunizations/CIIS, please contact Meredith Henry, 303-866-4538.