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A Bonaire Health Declaration Form is a legal, national form that certifies that the applicant is a qualified individual under the Medicaid program. The type is used by households and people who need health care to apply for assistance. Qualification criteria require that an individual be 18 years of age or older, be getting Medicaid, be in generally acceptable wellbeing, be a drug dependent, and not be financially liable for any component of the cost of any medical care given. This type can be collected by the regional Division of Family Services office. It's also accessible from sellers online. If you decide to order online, you will need to complete and return the form for a proof of earnings, your immunization records if appropriate, and information regarding your loved ones. A copy of your income tax form can also be needed. There are specific instructions on how to complete and complete these forms. You can Locate Them in the Florida Division of Family Services website. You can also contact them directly at -LRB-386-RRB- 830-5100 or faxing or mailing in the appropriate forms. Applications are often available from the beginning of February to the end of May. To apply for one of these forms, you must telephone, email or fax it to the Division of Family Services first. When you call the Division of Family Services, they will ask questions regarding why you're calling and to your own Personal Identification Number (PIN), which type of health coverage you need, and how many men and women are covered under your plan. You will also need to provide them your arrival date and social security number. This is usually done with a pen or voice-recognition software program. Once the agent has your data, they could start your application. As you complete your forms, you will receive a proof of your program, a statement which explains your situation, and the program is great to go. If you don't feel comfortable filling out the forms, you can speak with somebody else in the Department of Health and Welfare. You should also provide specific information about your dependents when completing the Bonaire Health Declaration Form. Your partner, domestic partner, children, parents, and stepchildren has to be listed on the form if you are filing jointly. Anybody who will be financially supporting you must also list them about this program. In addition to your information, you must also have details about some other persons that live in your household and have an impact on your wellbeing. For instance, a parent or spouse who will be receiving help to cover the child or children might have their information included. Though your application might seem a bit perplexing, the Department of Health and Welfare has made sure the types are simple to comprehend and won't cause any difficulties when you submit it. If you're having trouble understanding or completing the Bonaire Health Declaration Form, you can call the Department of Health and Welfare at -LRB-913-RRB- 595-7000 to speak with a representative. They will be able to assist you and answer any questions which you may have about how to complete this program. You can even see the complete forms on line at the department's website.