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New Application

Are you applying for the first time?  You will need to complete a New Application.  In order for your application to be approved, it is very important that you complete the entire application and include copies of all of your proof of income.  If you don’t have any income, call (717) 334-0206 in Adams County or (800) 429-2430 in York County.

You can get an application by:

  • Call (717) 334-0206 in Adams County or (800) 429-2430 in York County to have a copy mailed to you 
  • Contact or visit one of the locations listed below
    ~or~
  • Download and print an application from this site

Download the HYN New application – English Version  -  PDF 
  
Click here for one person applying (6 pages will print) 
  
Click here for each additional person applying (additional 3 pages print)
 
Download the HYN New application – Spanish Version - PDF 
 
Click here for one person applying (6 pages will print) 
 
Click here for each additional person applying (3 additional pages print)

 

After completing an application please send it to:
 

In Adams County:

Healthy York Network
1275 York Road, Suite 17
Gettysburg, PA  17325

 

In York County:

Healthy York Network
116 South George Street, Suite 101
York, PA  17401

 

Contact or visit any of the following locations to receive an application:

We now have a Healthy York Network caseworker located at the Family First Health new location at: Peebles Plaza 1275 York Road, Suite 17 in Gettysburg. 
 

In Adams County:

Family First Health
Gettysburg Center
Peebles Plaza
1275 York Road Suite 17
Gettysburg
Telephone: (717) 337-9400

SCCAP  (South Central  Community Action Program, Inc.)
153 North Stratton Street
Gettysburg
Telephone: (717) 334-7634

United Way of Adams County
123 Buford Avenue
Gettysburg
Telephone: (717) 334-5809

Gettysburg Hospital
147 Gettys Street
Gettysburg
Telephone: (717) 334-2121

Hanover Hospital
300 Highland Avenue
Hanover 17331
Telephone: (717) 637-3711

WellSpan Medical Group
Telephone: 851-6816 or
800-839-1404
 
WellSpan HealthSource
1001 South George Street
York
Telephone: (717) 851-3500

Adams County Assistance Office
225 South Franklin Street
PO Box 4446
Gettysburg
Telephone: 800-638-6816

 

 

In York County:

Community Progress Council
226 East College Avenue,
York
717-846-4600
 
213 E. Lancaster Avenue
Red Lion
717-417-3354
 
219 York Street
Hanover 17331
717-632-9191
 
Family First Health
South George Street Center
116 South George St., York
845-8617
 
Hannah Penn Center
415 E. Boundary Ave., York
843-5174
 
1230 High Street
Hanover 17331
(717) 632-9052
 
Hanover Hospital
300 Highland Avenue
Hanover 17331
(717) 637-3711
 
Memorial Hospital
325 South Belmont St.,
York
843-8623
 
United Way of York County
800 East King Street, York
843-0957
 
WellSpan HealthSource
1001 South George St.,
York
851-3500
 
WellSpan Medical Group
851-6816 or
1-800-839-1404

York City Bureau of Health
227 West Market St., York
849-2299
 
York County Assistance Office
130 N. Duke Street, York
771-1100
 
HealthConnect
van sites
www.wellspan.org
 
ForSight Vision
1380 Spahn Avenue, York
848-1630
www.forsight.org