Tools
The Department of Health’s website on eligibility policy for Medicaid
The Department of Health’s website on eligibility policy for CHIP
Enrollment Process Checklist
Department of Workforce Services
Medicaid/CHIP/UPP/PCN Application:
Medicaid/CHIP/UPP/PCN Application – Online Application
Medicaid/CHIP/UPP/PCN Application – Hard Copy Application
Medicaid/CHIP/PCN/UPP Application - Hard Copy Application (SPANISH)
Authorization Form – Family member signs this form to give you permission to access their information for enrollment process.
Authorization Form (SPANISH)
List of Required Documents for Enrollment
Income Guideline Flyer to use in your School
Examples of Outreach Materials for Schools:
Alpine School District Example
Example Brochure - Jordan School District
Health Services Department Example
Business Card Example
General Resources in Salt Lake County
Safety Net Dental Clinics in Utah
Please give us feedback on the Take Care Utah Tool Kit
Call Randal 801-433-2299 or email randal@healthpolicyproject.org
Would you like to be involved in policy work? As you or your school helps families qualify for coverage, you may have concerns with current policy or DWS practices. From our work with families we learn about what’s working and what’s not in current health policy. Contact UHPP and learn how to reach your state representative and/or senator to talk about health care in your community. Ask us for an advocacy training or training on the Affordable Care Act.
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