Complete and Submit an Application
The final step to apply to the World Trade Center (WTC) Health Program is to fill out the application. You can either apply online using the online system or download a form and send through mail or fax.
Please Note: A complete application is one that has a signed application form with all pages filled out, as well as all required supporting documentation included. Please make sure your application includes your full legal name and date of birth.
Do you want to designate someone to represent your interests when applying to the WTC Health Program or as a member? Learn how to officially Designate a Representative.
Option 1: Apply online
The easiest and fastest way to apply to the World Trade Center Health Program is through the online application system (OASIS) .
Please note that when applying online:
- You must submit a complete application that includes your supporting documentation, and
- You must print, sign, scan, and upload a completed signature form before your application can be submitted.
Online Application Signature Form and Program Notices [PDF, 8 pages, 341 KB]
Print and save a copy of your online application for your records. You will be given the option to print at the end of the online application process. We recommend you bring a copy of your application to your first appointment.
Option 2: Send the application by mail or fax
If you prefer to mail or fax the paper application, you can either print and complete by hand or download and complete the fillable pdf. You must then mail or fax in the application with the required supporting documentation.
Please note: The applications for enrollment are valid despite the 2021 expiration date. The Office of Management and Budget (OMB) is reviewing updated forms. The Program can continue using and accepting the current forms during this process.
You can download the application below:
FDNY Responder Eligibility Application:
Responder Eligibility Application (Other than FDNY):
- English [PDF, 12 pages, 824 KB]
- Español [PDF, 12 pages, 1.10 MB]
- Polskie [PDF, 14 pages, 1.71 MB]
- 中文 [PDF ,12 pages, 1.25 MB]
Survivor Eligibility Application:
- English [PDF, 11 pages, 380 KB]
- Español [PDF, 11 pages, 404 KB]
- Polskie [PDF, 13 pages, 997 KB]
- 中文 [PDF, 10 pages, 1.08 MB]
Pentagon/Shanksville Responder Eligibility Application:
Finalize your paper application
If you download a pdf application, you need to sign and date it. You must then print your pdf application and mail to the following address.
Send in your application and required supporting documentation by mail to:
For regular submissions:
WTC Health Program
P.O. Box 7000
Rensselaer, NY 12144
For FedEx or Certified Mail:
WTC Health Program
327 Columbia Turnpike
Rensselaer, NY 12144
Or you may fax your application and supporting documentation to:
Save a copy of your printed application for your records - We recommend you bring a copy of your application to your first appointment.
What happens next?
We will start processing your application as soon as it is received. After your application has been reviewed, we will either call and send you a letter asking for additional information or, if we have all the information needed, we will send you a letter letting you know if you are eligible for enrollment in the WTC Health Program.
If you are not accepted, the letter will explain how you can appeal that decision. If we have questions or if you do not have a complete application, we will call, email, or write to you.
If you have questions about the application process or about your individual application, please contact us toll-free at 1-888-982-4748 or email the Program at WTC@cdc.gov. Please note: We do NOT accept applications by email.
To protect your privacy, please do not email sensitive information, including personal health information.
WTC Health Program Notice of Privacy Practices — this notice describes how medical information about WTC Health Program members may be used and disclosed and how WTC Health Program members can get access to this information. The effective date for this notice is Monday, September 30, 2013.