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Attention Medicaid Participants: Eligibility Renewals Restarted April 1, 2023
Welcome Screening for Life service providers. This section will provide up-to-date information, screening guidelines, policy memos, newsletters, and forms. Visit this site regularly to look for new information and updates.
Send completed enrollment form to:
Screening for Life
540 S. DuPont Highway, Ste. 11
Dover, DE 19901
or email the form to the Screening for Life program.
Client Enrollment Form
Applicant Self-Attestation Form
Delaware Residency Verification Form
Employment Verification Form ( Applicant )
Employment Verification Form ( Spouse / Parent Guardian )
Financial Support Verification Form
Eligibility and Acceptable Information
Information Sheet ( What is SFL / HCC? )
Please Note: These forms require legal size (8.5" x 11") paper.
Return to Screening for Life home page.
Please note: Some of the files available on this page are in Adobe PDF format which requires Adobe Acrobat Reader. A free copy of Adobe Acrobat Reader can be downloaded directly from Adobe . If you are using an assistive technology unable to read Adobe PDF, please either view the corresponding text only version (if available) or visit Adobe's Accessibility Tools page.