Public Assistance Applications & Drop-Off Site

The general application for Public Assistance is required for individuals and families interested in applying for food assistance programs (SNAP), cash assistance programs (Colorado Works, Supplemental Security Income (SSI) supplement, disability, old age pension, or home care allowance), or medical assistance programs (Medicaid for adults, Child Health Plan Plus for children). Eligibility requirements are listed on the applications.

There are three versions available for download below, including English, Spanish, and large print English. Clients can also fill out the application online by visiting the State Peak website.

These applications can be filled out and dropped off at the secured Human Services Department office dropboxes located in the front and back of the building located at:
735 US Highway 24,
Leadville, CO 80461

Forms submitted in dropboxes are checked on a regular basis during regular office hours.

For help with these forms, reach the Public Assistance (PA) team with the numbers listed under "Contact Us" to the right.