If you have a medical condition that reduces your ability to work, take this form to your doctor and ask them to sign
it now. Even
if you are working now, it’s a good idea to get this form signed to protect your SNAP if your
hours change.
You can submit this signed form to the County Assistance Office to
keep your benefits. Get this medical exemption form signed soon! If you don’t, you could lose
your SNAP as soon as the beginning of December.
Click this to find out why
| Fill out and submit the form for any answers |
|---|
Based on the information you provided,
you [“do not have to” or “must”] prove
you are working or volunteering 20 hours a week to be able to receive SNAP.
