Assistance Applications and Forms
You can now apply by phone. Call 1 (844) 640-OHIO (6446) to apply for Supplemental Nutrition Assistance Program (SNAP), Cash assistance (Temporary Assistance to Needy Families), and Medicaid. An audio signature will be required if you apply by phone.
All printed applications can be submitted, in person, to our office. Applications can also be mailed to:
Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH 43950
If you need an application mailed to you, please call (740) 695-1075, extension 1130 or you can also click on one of the specific links listed below and submit the printed application to the BCDJFS.
Click on the application for the type of assistance you are seeking
Application for Cash, Supplemental Nutrition Assistance Program (SNAP), and/or Medicaid Benefits
(Click here for Application in Spanish)
Application for Health Coverage – ONLY
(Click here for Application in Spanish)
Application for Publicly Funded Child Care
Complete and print out the application
BRING THE COMPLETED APPLICATION TO OUR OFFICE
OR MAIL TO:
Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH 43950
OR FAX TO: (740) 695-5251
COMMONLY USED FORMS
SNAP / FOOD ASSISTANCE CHANGE REPORT FORM
Authorized Representative Form for ALL PROGRAMS
Authorized Representative Designation Form for Medicaid ONLY
New – Fraud Warning
New – Medicaid Rights and Responsibilities
New – Cash and SNAP Rights and Responsibilities
New – ABAWD OAC Rules
New – SNAP E&T OAC Rules
New – JOBS Rights and Responsibilities
All printed forms and verifications may be submitted in person at our office at 68145 Hammond Rd., St. Clairsville, OH 43950. Applications may also be mailed to the same address or faxed to (740) 695-5251.
Belmont County DJFS
68145 Hammond Rd.
St. Clairsville, OH 43950
Or fax to: (740) 695-5251