Forms and Service Center
1. Print out and complete application
2. Bring (or mail) to:
Lucas County Job & Family ServicesIf you choose to bring the application to our office at the above location, the office hours are 8:30 am - 4:30 pm.
3210 Monroe Street
P.O. Box 10007
Toledo, OH 43682-4139
Fax to: (419) 213-8820
Cash Assistance, Food Assistance or Medicaid
To access the Ohio online benefit Application:
Cash Assistance, Food Assistance or Medicaid application (JFS 7200)
Cash Assistance, Food Assistance or Medicaid application Spanish (JFS 7200S)
Healthy Start/Healthy Families Medicaid
To access the Ohio online benefit application:
Healthy Start/Healthy Families application (JFS 7216)
Spanish application (JFS 7216S)
Prevention, Retention, Contingency (PRC)
Subsidized Child Care
Non-Emergency Transportation Services
Do you need help getting back and forth to your medical appointments? If you are on Medicaid, do not have access to a vehicle, and your physician can verify a medical need, you may be eligible for our Non-Emergency Medicaid transportation program. This program will assist you by providing you a ride to and from your Ohio Medicaid providers located in Lucas County.
To apply for Non-Emergency Medical Transportation you will need to submit the following forms:
Reporting changes within 10 days to your case worker is very important. You will need to report a change if:
Even though the preferred method of change reporting is the online benefit application, you may also call the agency to report changes. Any change regarding Cash Assistance, Food Assistance, Medical or Work Activities, please contact the agency call center at 419-213-8800 or 419-213-8900. For general information call the Job & Family Services operator at 419-213-8999.
You can also drop your documents off in person at 3210 Monroe Street, Toledo Ohio, 43606 at the Document Drop Off Center from 8:30 am - 4:30 pm. The Document Drop Off Center will scan your document(s) and send it to the worker, electronically, giving you back your original document. It is best to bring in original documents as they scan at a higher quality. A receipt of your scanned document(s) is available upon request.
Designation of Authorized Representative (LCJFS 1473)
Direct Deposit Authorization (ODJFS 7344)
Employment Verification Form (LCJFS 12)
Interim Report (Spanish)
Landlord Inquiry Form (LCJFS 1224)
Request to Reapply for Cash and Food Assistance (ODJFS 7204)
Sanction Compliance Agreement (3804)