New Hampshire Department of Health and Human Services - Bureau of Family Assistance Forms
The New Hampshire Department of Health and Human Services - Bureau of Family Assistance (BFA) is responsible for administering various assistance programs in the state. These programs aim to provide support and resources to eligible individuals and families who are in need of financial assistance, healthcare coverage, and other essential services. Some of the key programs offered by the BFA include Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Medicaid, Child Care Assistance, and Emergency Assistance. The BFA aims to improve the well-being and quality of life for New Hampshire residents by helping them meet their basic needs and achieve self-sufficiency.
Documents:
93
This form is used for physicians and psychologists in New Hampshire to provide a statement of their capabilities. It is required for certain purposes such as disability claims or medical evaluations.
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This form is used for authorizing the release of protected health information in New Hampshire.
This document is used for applying for Medicaid in New Hampshire through the Presumptive Eligibility CFI/HCBC program.
This document is used for reimbursement agreements and acknowledgments in the state of New Hampshire. It is a form that helps individuals and organizations in the state to facilitate reimbursements.
This Form is used for requesting to determine Presumptive Eligibility (PE) in New Hampshire.
This form is used for applying for Family Planning Medical Assistance (FPMA) in New Hampshire.
This form is used for determining the incapacity status in New Hampshire.
This Form is used for declaring an Authorized Representative (AR) in New Hampshire.
This Form is used for submitting the declaration of authorized representative (RA) in New Hampshire.
This document is used for applying for health coverage and financial assistance in New Hampshire.
This form is used for the certification of continuous absence in New Hampshire.
This Form is used for attesting and verifying the disaster experienced by the household receiving food stamps in New Hampshire.
This form is used for applying for Medicaid Presumptive Eligibility (PE) in the state of New Hampshire.
This type of document is used to apply for Presumptive Eligibility (PE) for Medicaid in New Hampshire.
This form is used for notifying individuals in New Hampshire about their presumptive eligibility for certain benefits.
This form is used for attestation and verification of a food stamp household disaster in New Hampshire.
This form is used for New Hampshire physicians or clinicians to provide a statement of their capabilities as part of the BFA Form 752.
This form is used for requesting authorization to release information in the state of New Hampshire. It is typically used in a business or legal context.
This document is used for clients in New Hampshire to provide a statement of their financial information.
This form is used for authorizing the release of protected health information for fanf financial assistance in New Hampshire.
This document grants permission to disclose protected health information for the purpose of financial assistance application.
This form is used for healthcare providers in New Hampshire to document the necessary care needed for a family member in the Fanf household.
This document is used for determining incapacities for financial assistance in the state of New Hampshire.
This document is in Spanish and is used in New Hampshire. It is a form (Formulario 720) for determining incapacity in order to apply for financial assistance from the Fanf program.
This form is used for applying for BFA Form 811R in New Hampshire and outlines the rights and responsibilities of the applicant.
This document is a BFA Formulario 811R Solicitud that provides information about your rights and responsibilities in the state of New Hampshire. It is written in Spanish.
This Form is used for citizens of New Hampshire to request assistance from the Department of Foreign Affairs (DFA) in cases requiring support for a community or town.
This document provides information on how to file an unresolved food stamp complaint in New Hampshire.
