Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: UPDATE TO APPLICATION REQUEST (IM-1REQ) FOR ALL MO HEALTHNET (MHN) PROGRAMS
FORM REVISION #
The IM-1REQ has been updated to be used for all MHN programs, including Family MO HealthNet programs and MO HealthNet for the Aged, Blind, and Disabled programs.
Family Support Division staff mail the IM-1REQ and an Application for Health Coverage & Help Paying Costs (IM-1SSL) when an individual requests a paper application.
The IM-1REQ is now available to staff only in the FSD Intranet Income Maintenance (IM) Forms Manual.
- Review this memorandum with appropriate staff.