Enrollment/ Forms

How Do I Sign Up?

Download the application for and complete the application and take it to the Family PACT coordinator in SHCS to see if you are eligible to receive your Health Access Plan (HAP) card.

You can ask questions about  enrollment when you meet with the coordinator. Please save your questions regarding medical issues for your healthcare provider.

Family PACT Forms (in PDF forms):

• Family PACT Services
• Application for Family PACT: Client Eligibility Form

For more information about Family PACT, you can also visit their website: familypact.org