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