Spbp renewal application 2026

1. Click ‘Get Form’ to open the spbp renewal application in the editor.
2. Begin by entering your full legal name, sex, date of birth, and language preference in Section 1. If you are re-enrolling, include your SPBP identification number.
3. In Section 2, provide your principal place of residence. Ensure that the address matches the proof of residency you will submit.
4. For Section 3, enter your Social Security Number. If you do not have one, check the appropriate box. Note that re-enrollment does not require a Social Security Card.
5. Complete Sections 4 through 12 by providing required information about ethnicity, case manager details, family composition, health insurance coverage, and income verification as outlined in the instructions.
6. Review all entered information for accuracy before signing and dating your application in Section 11. If applicable for new enrollment, ensure your prescribing clinician signs Section 12.

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