Program Forms and Outreach Materials

Safe at Home Program Applicants:

The Safe at Home program application is not available online. You must make an appointment with a certified enrolling agency to complete the application in person. Please consult the Enrolling Agency Referral List to make an appointment with an enrolling agency near you. For more information about enrollment in the Safe at Home program, please visit the enrollment page or contact the Safe at Home program at (877) 322-5227.

Certified Enrolling Agency Advocates:

The following forms are for Certified Safe at Home Enrolling Agency Advocates, only. For more information about becoming a Certified Safe at Home Enrolling Agency, please visit the enrolling agencies page or contact the Safe at Home program at (877) 322-5227.