Printable Documents:

• Early Intervention Program Application - English (PDF,1940 kb)

• Early Intervention Program Application - Spanish (PDF,1958 kb)

Program Information:

• HIV Client Services

• Early Intervention Program

Related Information:

• Links

• Ask EIP

Some files on this page require free readers.  Download a reader.

EIP Application

• You can download the application by clicking one of the links to the left
•  Available in English (PDF,1940 kb) and Spanish (PDF,1958 kb)

Early Intervention Program requirements:

• Be HIV+
• Live in Washington State
• Have family income at or below 300% Federal Poverty Level (FPL). Up to 370% FPL if eligible for EIP before 9/1/2002..
• Have family resources of $10,000 or less (not counting your home, one automobile per licensed driver and some retirement funds)

Clients with income of 100% or less than Federal Poverty Level ($867 in 2008 for a single person) will have to apply for Medicaid.  Clients who have previously been denied Medicaid may not be required to apply with Medicaid again.  EIP will send Medicaid application information to clients and provide temporary EIP coverage during the Medicaid application period.  You can download a Medicaid application by visiting their website. 

Eligibility and services are subject to change.  Please call us for additional information at 360-236-3426 or 877-376-9316 (toll free).

Alternative File Format Information
Documents posted in .pdf version on the Department of Health web site will be made available on request to users who are unable to download or view them.  For persons with disabilities, .pdf documents will be made available on request in other formats.  To submit a request, contact:  Robin.Vaughn@doh.wa.gov  or call 360-236-3398.

DOH Home | Access Washington | Privacy Notice | Disclaimer/Copyright Information

Washington State Department of Health
HIV Client Services
P.O. Box 47841
Olympia, Washington, 98504-7841

Last Update : 07/22/2008 02:46 PM
Send inquires about DOH and its programs to the Health Consumer Assistance Office
Comments or questions regarding this web site? Send mail to Robin Vaughn.