Stage 2 Fire Restrictions Enacted for Western Boulder County; Stage 1 Fire Restrictions Enacted for Eastern Boulder County.

Public Assistance Benefits Forms

Public Assistance Benefits Forms

Notice to Reapply

Use this form to reapply for any of these programs:

  • Food Assistance (SNAP)
  • Medicaid (Health First Colorado)
  • Colorado Works
  • Adult Financial

Notice to Reapply (La Nota Para Aplicar)

Application for Public Assistance

Colorado PEAK is a free state website. You can use it to apply for health, food, and cash help. We recommend applying this way for:

  • Food Assistance (SNAP)
  • Medicaid (Health First Colorado)
  • Colorado Works
  • Adult Financial

See if you qualify and apply through Colorado PEAK.

If you prefer a paper application, use this Application for Public Assistance form.

We also offer a Digital Application for Public Assistance (Solicitud digital de asistencia publica)

Change Report Form

Use this form to report changes to your case. Examples include:

  • Income
  • Address
  • Household members
  • Monthly expenses

Programs include:

  • Food Assistance (SNAP)
  • Medicaid (Health First Colorado)
  • Colorado Works
  • Adult Financial

You must report required changes within the time limits for your program.

Change Report Form (Formulario de informe de cambios)

Child Care Assistance

The Child Care Assistance Program (CCAP) helps low-income families pay for childcare for children from birth through age 12. If you qualify, CCAP pays part of the cost, and you pay the rest based on your income and family size.

Enrollment Freeze
Boulder County CCAP is currently on an enrollment freeze. This means:

  • We are only taking applications for the waitlist.
  • Families already in CCAP can stay if they still qualify and recertify each year.

To see if you might qualify during the freeze, fill out the Prescreening Questionnaire. If you qualify, we will add your name to the waitlist.

If your family is already in CCAP, you must turn in a Redetermination Form each year to stay in the program.

Contact Us

Human Services

Phone: 303-441-1000
TTY: 1-800-659-3656
Fax: 303-441-1523
Submit a question

Mailing Address
P.O. Box 471
Boulder, CO 80306

Boulder Location

3460 Broadway, Boulder
Fax: 720-564-2283
Hours: 8 a.m. - 4:30 p.m. Monday/Wednesday/Friday

Longmont Location

515 Coffman St., Longmont
Hours: 8 a.m. - 4:30 p.m.
Monday-Friday

Lafayette Location

1755 S. Public Road, Lafayette
Hours: 8 a.m. - 4:30 p.m.
Tuesday/Thursday
Closed 1-2 p.m. for lunch.

Human Services website