Fsp application 2026

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The Family Support Program (FSP) Application Packet outlines the process for applying to the FSP, which is administered by the Department of Healthcare and Family Services (HFS) with support from eQHealth Solutions, Inc. It details the necessary documentation required for application submission, including financial information, behavioral health treatment history, and eligibility determination requests. The packet emphasizes the responsibilities of parents or guardians in participating in the program and provides instructions for submitting applications via fax or mail.

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Click ‘Get Form’ to open the FSP application in our editor.
Begin with Section 1, General Information. Fill in the youth's name, Social Security Number, date of birth, and contact details. Ensure accuracy as this information is crucial for eligibility.
Move to Section 2, Family Financial Information. Provide details about income, insurance coverage, and any financial resources. Attach necessary documents like tax returns directly within the platform.
In Section 3, document the youth’s Behavioral Health Treatment History over the past year. Include all relevant services received and medications taken.
Review Section 4 carefully and initial next to each responsibility listed to confirm your understanding and agreement.
Complete Section 5 by signing the Request for Eligibility Determination. This confirms that you have reviewed all information provided.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (244 Votes)

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