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848 Third Ave
Gallipolis, Ohio 45631
Phone: (740) 446-3222
Toll Free: 1-800-371-5987
Fax: (740) 441-2108
Hours: Monday-Thursday
7:00 am - 5:00 pm

 

Forms and Waivers

 

JFS 07200 Request for Cash, Food Stamps & Medical Assistance

 (English, Spanish)

 

JFS 07103 Application for Help with Medicare Expenses

(English, Spanish)

 

JFS 07216 Healthy Start/Healthy Families Combined Program Application (English, Spanish)

 

In compiling this data, Gallia County/Gallipolis City has made every effort to ensure the accuracy of this data, however no guarantee is given or implied. In no event shall Gallia County/Gallipolis City or it’s employees be held liable for any loss or damage, consequential or otherwise, including but not limited to time, money or goodwill, arising from the use, operation or modification of the data or information.  No person, entity or user shall sell, give or receive for the purpose of selling or offering for sale, any portion of the information or data provided herein, nor may they use the information in a manner that is in violation of any federal, state or local law or regulation. This institution is an Equal Opportunity Provider