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HealthFacts Rhode Island Application for Custom REQUESTS (Copy of Online Application)*** Please be advised that applicants are unable to save and return to the online application form, and therefore
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The copy of online application is a duplicate of the original application submitted electronically.
All applicants are required to file a copy of their online application.
To fill out the copy of online application, simply print out a PDF or paper copy of the completed online application form.
The purpose of the copy of online application is to provide a physical record of the electronically submitted application.
The copy of online application must include all the same information as the original online application, including personal details, qualifications, and any supporting documents.
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