COLS Online Intake
Steps
1
. Initial Info
2
. Initial Information
3
. Financial Information
4
. Legal Problem
5
. Contact Information
6
. Demographics
7
. Adverse Party
8
. Review Application
9
. Exit
Initial Info
Introduction
Page Two
Page Three
Page Four
Welcome!
• If you are being terminated from Medicaid and are 60 or older, please call 303-837-1313.
• Answer the questions in this application to request help from Colorado Legal Services.
• DO NOT
both apply at a local office and online. If you did apply online and you call a local office, let them know you completed an online application.
Click here
to view a list of Colorado Legal Services offices.
• Understand that applying online does not automatically mean you will be eligible for our services, or that we will be able to help you. This information will help us figure out if we can help you.
Click "Continue" below if you'd like to complete an online application.