Apply

Are you ready to apply?
It is easy!

There are 3 ways to apply.
1.)  Simply print an application form (link is below), follow the instructions, enclose all necessary documents, and mail it to the address on the application form.

Application Instructions
Application
Signed Release Forms English – Spanish
(must be returned with your application)

2.)  Complete the application at a local registration (intake) site. You must call the registration site for an appointment and bring necessary documentation. Intake site location list below.

3.)  Call (708) 531-0680 and request an application be mailed to you. When received, follow the instructions and enclose the necessary documents.

Please note: Without all the necessary documentation, your application will be delayed.

Access to Care Intake sites:
(PDF available here)
* Spanish spoken

North

Access at Northwest Community Hospital | Arlington Heights | (847) 342-1554 | Visit website

Access Genesis Center for Health and Empowerment | Des Plaines | (847) 298-3150 | Visit website

Barrington Township | Barrington | (847) 381-5632 | Visit website

City of Des Plaines | Des Plaines | (847) 391-5481 | Visit website

Elk Grove Township | Arlington Heights | 847-437-0300 | Visit website

Evanston Township | Evanston | (847) 475-4481 | Visit website

Evanston Township Health Department | Evanston | (847) 866-2948 | Visit website

Frisbie Senior Center | Des Plaines | (847) 768-5944 | Visit website

Greater Elgin Family Care Center – Creekside Health Center* | Wheeling | (847) 608-1344 | Visit website

Greater Elgin Family Care Center – McHenry Health Center* | McHenry | (815) 363-9900 | Visit website

Greater Elgin Family Care Center – Seneca Health Center* | Elgin | (847) 608-1344 | Visit website

Greater Elgin Family Care Center – Streamwood Health Center* | Streamwood | (847) 608-1344 | Visit website

Greater Elgin Family Care Center – Summit Health Center* | Elgin | (847) 608-1344 | Visit website

Hanover Township* | Bartlett | (630) 540-9085 | Visit website

Maine Township* | Park Ridge | (847) 297-2510 | Visit website

Niles Township | Skokie | (847) 673-9300  | Visit website

Northfield Township* | Glenview | (847) 724-8300 | Visit website

Northwest Compass* | Mt. Prospect | (847) 392-2344 | Visit website

Omni Youth Services* | Arlington Heights | (847) 353-1500 | Visit website

Palatine Township | Palatine | (847) 358-6700 | Visit website

Schaumburg Township | Hoffman Estates | (847) 884-0030 | Visit website

Village of Arlington Heights | Arlington Heights | (847) 368-5791 | Visit website

Village of Mt. Prospect* | Mt. Prospect | (847) 870-5680 | Visit website

Village of Schaumburg | Schaumburg | (847) 923-3766 | Visit website

Village of Wheeling | Wheeling | 847-459-2606 | Visit website

Vista Health Center* | Arlington Heights | (847) 934-7969 | Visit website

Wheeling Township* | Arlington Heights | (847) 259-7730 | Visit website

South & Chicago

Access Family Health Society* | Chicago Heights | (708) 754-9687 | Visit website

Arab American Action Network | Chicago | (773) 436-6060 | Visit website

Aunt Martha’s Community Health Center* | Harvey | (708) 333-1095 | Visit website

Aunt Martha’s Chicago Hts. Community Health Center | Chicago Heights | (708) 756-1135 | Visit website

Bremen Township | Markham | (708) 333-9530  | Visit website

Cook County Department of Public Health | Bridgeview | (708) 974-6160

Orland Township | Orland Park | (708) 403-4222 | Visit website

Palos Township | Palos Hills  (708) 598-2218  |  Visit website

Park Forest Health Department | Park Forest | (708) 748-1118

Rich Township | Richton Park | (708) 748-6722 | Visit website

Southland Ministerial Health Network| (708) 288-8488| Visit website

Thornton Township* | South Holland | (708) 596-6040 | Visit website

Worth Township | Alsip | (708) 371-2900 | Visit website

West

Arab American Family Services | Bridgeview | (708) 599-2237 | Visit website

Berwyn Township* | Berwyn | (708) 788-6600 | Visit website

DesPlaines Valley Health Center* | Argo-Summit | (708) 458-0757

Leyden Township | Franklin Park | (847) 455-8616 | Visit website

Norwood Park Township | Norridge | (708) 453-0861

Oak Park Health Department | Oak Park | (708) 383-6400 | Visit website

Oak Park – River Forest Food Pantry | Oak Park | (708) 386-1324 x1106 | Visit website

Proviso Township* | Hillside | (708) 449-4307 | Visit website

Proviso-Leyden Council for Community Action* | Maywood | (708) 450-3500 | Visit website

Town of Cicero* | Cicero | (708) 656-3600 | Visit website