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Owner: Health and Social Services, Social Services
Link: http://dhss.delaware.gov/dss/files/chip_appl_engl.pdf
Referring Page - Delaware Healthy Children Program
Description: Complete and sign this application form to apply for the Delaware Healthy Children Program,
which offers affordable health insurance to uninsured children. You will pay a low monthly
premium based on family income.
You can also use this form to apply for Medicaid's Diamond State Health Plan for individuals and
families.
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Standard PDF - This type of document can be Viewed and Printed online however, normally it can not be edited or filled-in. To open this type of document you will need to have an application installed on your computer that can read portable document files (PDF). Adobe Acrobat Reader is a free viewer that will allow you to open this type of file. Get Adobe Acrobat
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Last Updated: Friday, 22-Aug-2008
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