Senior Box (CSFP) Agency Resources
Click the “+” next to each section to see associated forms.
Civil Rights
Client Benefit Resources
CSFP Client Annual Validation
Client Handouts
CSFP Forms
- CSFP Beneficiary Referral Request (English)
- CSFP Beneficiary Referral Request (Spanish)
- CSFP Written Notice of Beneficiary Rights (English)
- CSFP Written Notice of Beneficiary Rights (Spanish)
- CSFP Proxy Form
- CSFP Senior Box Intake Form 2022 (English)
- CSFP Senior Box Intake Form 2021 (Spanish)
- CSFP Participant Application Instructions Revised March 2021
- CSFP Participant Application Revised March 2021
- Instructions for CSFP Applicant Notification (H1515)
- CSFP Application Notification (Form H1515)
- CSFP Participant Rights and Responsibilities (Form H1516)
- Certificate Expiration Notice (English)
- Certificate Expiration Notice (Spanish)
CSFP Training Videos
CSFP Management Tools
- Senior Program Income Guidelines 2022
- CSFP Monthly Report Tracker
- Oasis Insight Report Directions
- Senior Box Distribution Procedures – All Month Model
- Senior Box Distribution Procedures – Once a Month
- CSFP Senior Box Best Practices Checklist (English)
- CSFP Senior Box Best Practices Checklist (Spanish)
- CSFP Oasis Insight User Confidentiality Agreement
- CSFP Senior Box Steps for Signing Up A Senior Box Client
- Senior Box Pre/Post Distribution Procedures CHEAT SHEET