Health

Authorized Representative

In order to speak on the behalf of, gather any information about, the individual receiving benefits, you must get this Authorized Representative Form (PDF) signed and into the proper Human Services area.

USDA Nondiscrimination Statement

To file a complaint of discrimination regarding a program receiving Federal financial assistance through the U.S. Department of Health and Human Services (HHS), contact: 

HHS Director, Office for Civil Rights
200 Independence Avenue SW
Room 515-F
Washington, D.C. 20201
Phone: 202-619-0403 (voice) or 800-537-7697 (TTY)