Florida Medicaid Forms
The official forms a Florida long-term care Medicaid application uses, what each one does, and who has to sign it.
A Florida Medicaid application runs on a handful of authorization forms that let the Department of Children and Families (DCF) verify financial information and deal with whoever is handling the case, plus one medical certification that establishes the need for care. Each is a short, free, official form — print, complete, and bring the ones that apply to the first meeting. The links below go to the issuing agency's own site, not a third-party form service.
CF-ES 2337 — Financial Information Release
Authorizes DCF to verify the applicant's bank accounts, retirement accounts, and other financial holdings directly with the financial institution. Without it, DCF cannot confirm the asset figures the application reports.
Who signs it: The Medicaid applicant, or their designated representative once one has been appointed.
View the official formCF-ES 2339 — Appointment of a Designated Representative
Names the person DCF will deal with on the case — an adult child, an elder law attorney, or anyone else the applicant or their legal representative chooses to handle the application.
Who signs it: The applicant, or whoever holds legal authority to act for them (an agent under a power of attorney, or a guardian), together with the person accepting the appointment.
View the official formCF-ES 2613 — Authorization to Disclose Information
A general release letting DCF share and request case information with a named third party — a nursing facility, an attorney, or a family member who is not the designated representative.
Who signs it: The applicant or their designated representative.
View the official formAHCA 5000-3008 — Medical Certification for Medicaid Long-Term Care Services and Patient Transfer Form
Certifies that the applicant needs a nursing-facility level of care. This is the form the CARES medical assessment is built around, and the nursing home usually arranges for it to be completed.
Who signs it: The applicant's treating physician.
View the official formTwo tools to get ready
The forms above are DCF's, and DCF requires them. The two items below are ours — a checklist of every document a Florida Medicaid application typically needs, and a bundled copy of the DCF authorization forms in one PDF.
Medicaid Documentation Checklist
Every document a Florida Medicaid application needs — identification, income, 5 years of bank statements, real estate, legal documents, transfers, and more. Print and tick off as you collect.
Florida Medicaid Authorization Forms
The authorization and release forms above, bundled into one PDF to print and bring to the first meeting.
Open PDF →Filling these forms out correctly is the easy part. Making sure the application behind them does not run into one of the fifteen common pitfalls is where most of the work is. Return to the Resources hub for the current Medicaid figures.
Frequently asked questions
What DCF forms does a Florida Medicaid application need?
At minimum, the Financial Information Release (CF-ES 2337) and, if someone other than the applicant is handling the case, the Appointment of a Designated Representative (CF-ES 2339). DCF may also require the Authorization to Disclose Information (CF-ES 2613) to share case information with a third party.
Who fills out the medical certification form for nursing home Medicaid?
The applicant's treating physician completes the medical certification (AHCA form 5000-3008), certifying the need for a nursing-facility level of care. The nursing home usually arranges for this once the CARES assessment process begins.
Where do I get the official DCF Medicaid forms?
Directly from Florida DCF's own forms library, linked from each form below — not from a third-party form site, which can host an outdated version.