The forms listed below can be downloaded, printed and mailed to our office. Also included is information assisting in applying for DFCS programs.

• Form 66 (Rev. 07/09) - Inquiry Screening for Childcare Services
• Childcare Required Appointment Verification List
• Form 297 (Rev. 10/06) - Application for Benefits (Food Stamps, Medicaid, Temporary Assistance for Needy Families (TANF))
  
• Form 297I (Rev. 10/06) - Application Information
• Form 297 OR (SP) (Rev. 08/04) - Aplicacion Para TANF, Estampillas Para Comida O Asistencia Medica
• Form 297A (Rev. 10/06) - Rights and Responsibilities
• Form 297A (SP) (Rev. 10/06) - Derochos Y Responsabildades
• Verification Checklist (For Food Stamps, Medicaid, and TANF Benefits)
• Verification Checklist (SP) (For Food Stamps, Medicaid, and TANF Benefits)(SP)
  
• Form 297M (Rev. 10/06) - Medicaid Addendum
• Form 297M-SP (Rev. 10/06) - Medicaid Addendum
• Form 94 (Rev. 12/03) - Medicaid Application
  
• Form 94(SP) (Rev. 12/03) - Soliticitud De Medicaid
• Clayton County Medicaid Verification Checklist
• Form DMA-285 (Rev. 01/06) - Health Insurance Information Questionnaire
  
• Form 5460 (Rev. 06/05) - Notice of Privacy Practices - GDHR
• Form 5460 (SP) (Rev. 06/05) - Notice of Privacy Practices - GDHR
• Affidavit to Establish Identity for Medicaid for Applicants/Recipients Under Age 16
• Declaration of Citizenship/Alien Status (Rev. 2/07)
• Declaration of Citizenship/Alien Status (SP) (Rev. 2/07)
  
• Pick an Elf Program Information
  

Food Stamp Application - Available online at http://dfcs.dhr.georgia.gov/02/dhr/dfcs/ home/0,2224,3815890,00.html. A directory of county offices with contact information, including fax numbers is available.

DHR Web site - Visit the DHR Web site for more on Adult Protective Services; Child Abuse & Neglect; Emergency Food Assistance; Adoption Services; Energy Assistance; Food Stamps; Food Stamps - En Español; Foster Care; Medicaid; Refugee Resettlement; Secret Santa Program; Subsidized Child Care; and Temporary Assistance for Needy Families.

DHR Fact Sheets - Information sheets from DHR on Children Services; DHR Divisions & Offices; Disease Information; Family Services; Health Services; Senior Services

Check Tracking from DHR - Georgia DHR check tracking application

Georgia Department of Community Health Web site - Lead planning agency for all health issues in the state such as health care policy, purchasing and regulation. The department is responsible for: Insuring nearly 2 million people; Maximizing the state’s health care purchasing power; Planning coverage for uninsured Georgians; Coordinating health planning for state agencies.

Click here to Suggest an E-Service

(English) - We have a Spanish line for our Hispanic customers who may have questions regarding their benefits or any other concern. For assistance they can call 770-473-2324.

(Version en Español) - Tenemos una linea en espanol para nuestros clientes de habla hispana si tienen preguntas con respecto a sus casos o algun otro interes. Para assistencia pueden llamar al numero siete, siete, cero; cuatro siete tres; dos, tres, cuatro (770-473-2324).

E-mail Us | Directions to Our Office

FOR CHILD SUPPORT ENFORCEMENT INFORMATION OR QUESTIONS,
PLEASE VISIT WWW.CSE.DHR.STATE.GA.US.

Adult Protective Services (APS) | Child Protective Services | Childcare | Employment Services & Opportunties

Food Stamps | Foster Care & Adoptions | Medicaid | Social Security

Temporary Assistance for Needy Families (TANF) | Volunteer Opportunities

Clayton County Cares - Human Services Directory | Pick an Elf Holiday Program | Observed State Holidays