The Forms and Worksheets

Forms and worksheets that you may need to include with your application can be downloaded from this page.

Employment Verification Form
This form can be filled out by an employer as a verification of wages earned.

Self Employment Form
This form can be used to report income if you are self employed.

Identification Form for Children Under 16
This form can be used to take to your child's school or day care to prove identity.  *Note: Children 16 or older need to send a photo ID.

Healthy Kids Silver Automatic Premium Withdrawal
Use this form to authorize NHHK to automatically withdraw your premium payments from your bank account.

Healthy Kids Buy-In Automatic Premium Withdrawal
Use this form to authorize NHHK to automatically withdraw your premium payments from your bank account.

If you are already enrolled on Healthy Kids, click here.