Form DHS-6696-ENG Application for Health Coverage and Help Paying Costs - Minnesota

Form DHS-6696-ENG Application for Health Coverage and Help Paying Costs - Minnesota

What Is Form DHS-6696-ENG?

This is a legal form that was released by the Minnesota Department of Human Services - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the Minnesota Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DHS-6696-ENG by clicking the link below or browse more documents and templates provided by the Minnesota Department of Human Services.

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Download Form DHS-6696-ENG Application for Health Coverage and Help Paying Costs - Minnesota

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