Deb Etheridge

Applications for Public Assistance

Use the links below to apply.

  • Complete a paper Application for Services and send by mail, fax, email, in-person/lobby drop box, direct secure messaging (requires a DSM account), or through a fee agent.
  • Contact the Virtual Contact Center 800-478-7778 (TDD/Alaska Relay: 7-1-1) and apply for benefits over the phone
  • One Fax for All Offices - DPA’s statewide toll-free fax number is 888-269-6520, and Anchorage area residents can dial 907-269-6520.
  • See our Contact Us page for more information.

Tips For Faster Service - Give Proof Before We Ask
Service Tip to Help Avoid a Pend
Copies of applications are available at local offices, and we can mail one to you if asked.
An electronic application is not available for programs other than MAGI (income-based) Medicaid at this time.

Medicaid Applicants please note:

  • Income-based Medicaid applicants are encouraged to apply at This is the fastest way to see if you’re covered.
  • Older age or disability Medicaid applicants should only use the following (paper) application at this time:

(for most assistance programs)

Other Applications

Review or Recertification

  • The Eligibility Review Form (GEN-72) can be used for most programs. The division sends a prefilled review application form with the standard recertification or review notice.
  • Please note the reporting requirements for our programs, which can be reported directly to your local office, with a GEN-72 or other form.

Other Forms

More Public Assistance forms can be found on our Forms and Information page.

Registered to Vote?