New Jersey FamilyCare simplifies enrollment process with new one page application available for use as of July 1, 2005. This one-page application also serves as the application for Presumptive Eligibility for NJ FamilyCare. Stay tuned for more information about online enrollment. To download one page application, click here or to order forms fax a written request on your provider letterhead to the DMAHS General Services Unit at (609) 584-4383 or you can mail your request to:
DMAHS General Services Unit Mail Code 27 P.O. Box 712 Trenton, NJ 08625 Attention: NJ FamilyCare Program (forms)