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> Departments > Human Services > Food/Medical/Financial Assistance > CCAP > Redetermination Forms

CCAP Redetermination Forms

For your convenience, you may print out the necessary redetermination forms by clicking on the links below. We also recommend using the Redetermination Frequently Asked Questions document.

  • LCHS 4251 6-month re-determination [pdf]
  • SS-7 Redetermination of Eligibility form
  • LCHS 4250 Individual Assessment
  • LCHS 4225 Unrelated Individual Questionnaire
  • LCHS 4274 School Out Days - Poudre & Thompson R2-J School Districts
  • LCHS 4274 School Out Days - Park School District
  • LCHS 4214 IRC (Individual Responsibility Contract)

Spanish Versions

  • LCHS 4251 re-determinación de 6 meses
  • LCHS 4250 Evaluación Individual
  • LCHS 4225 Cuestionario Del Individuo No Relacionado
  • LCHS 4274 Dias Afuera De La Escuela - El Distrito de la Escuela de Poudre & Thompson R2-J
  • LCHS 4274 Dias Afuera De La Escuela - El Distrito de la Escuela de Park
  • LCHS 4214 Contrato De Responsabilidad Individual

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