Self-Help forms and Online Resources relating to Elder Law issues.
Click on a resource category listed below to see information related to that category.
PA Health Law Project Toll-Free Helpline - Call: 1-800-274-3258
The PA Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call the PHLP Helpline at 1-800-274-3258 or 1-866-236-6310 TTY or e-mail the PHLP at staff@phlp.org. Information from the PHLP is also available online at www.phlp.org. The Toll Free Helpline is open on Mondays and Wednesdays beginning at 8:00 AM Eastern.
Application for a Social Security Card
From the Social Security Administration: Use this form to apply for (1) An original Social Security card; (2) A replacement Social Security card; or (3) A change of information on your record. [PDF]
Application for Payment of Medicare Premiums, Coinsurance and Deductibles [PDF]
The PA 600M is a mail-in application for payment of the Medicare Part B premium only. It is used to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare Part B premium. A face-to-face interview is not required when using this application. The application cannot be used to apply for Medicaid (Medical Assistance), cash assistance or food stamps. (PA 600 M (AS) 8/19)
Applying and Appealing for Disability at Social Security (Video)
Watch this video from CTLawHelp.org to learn about how to apply and appeal for disability at Social Security. This video covers federal laws so the information in it is true no matter what state you live in. (2013)
Apply Online For Social Security Retirement Benefits
The Social Security Retirement benefit is a monthly check that replaces part of your income when you reduce your hours or stop working altogether. It may not replace all your income so it's best to identify other ways to pay for your monthly expenses as you age.
Benefits Check Up for Seniors
BenefitsCheckUp® connects millions of older adults and people with disabilities with benefits programs that can help pay for health care, medicine, food, utilities, and more.
Benefits Eligibility Screening Tool (BEST)
On SSA BEST, you can use the Benefit Eligibility Screening Tool (BEST) to find Social Security benefits you may be eligible to receive. It is not an application for benefits and will not send you free money.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Medical Assistance Financial Eligibility Application for Long-Term Care Supports and Services
Application for a determination of financial eligibility for long term care facilities. (PA 600-L Form) The person who needs help to pay for nursing facility care, or someone acting on his behalf, may complete the form.
Medicare Drug Plan Finder
The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.
Online Services: Apply For Retirement, Disability or Medicare Benefits and Other Services from the Social Security Administration
From the webpage of the Social Security Administration, you can apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and more – from anywhere and from any of your devices!
Request for Social Security Earnings Information
This form will request verification of employment dates from the Social Security Administration. You may need this if you are having difficulty obtaining dates of employment for a pension, social security application, or personal reason. Please note: fees apply depending on the number of years you are requesting. [PDF] (02-2021) FREE yearly totals of earnings are available at www.ssa.gov/myaccount. (11/20224)
Social Security Benefit Application - Medicare
Online Medicare application from the Social Security Administration.
Social Security Retirement Estimator
The Retirement Estimator produces estimates that are based on your actual Social Security earnings record and has been rated the Federal Government's Best Online Service.
Survivors Planner: Planning For Your Survivors
Information from the Social Security Administration about help it can provide for your survivors when you die if you have earned enough Social Security credits through your work.
Northampton County: Protection From Abuse Information
Information on Protection From Abuse services in Northampton county. Under the Protection From Abuse Act, you may file for an order if the person who has or is trying to harm you is/was your spouse; was living with you in a common-law marriage or as your boyfriend/girlfriend; the parent of your child; your child; was a sexual or intimate partner; your parent; or related to you by blood or marriage.
Philadelphia Court of Common Pleas Forms Center
Forms available from the Philadelphia County Court of Common Pleas
Application for a Social Security Card
From the Social Security Administration: Use this form to apply for (1) An original Social Security card; (2) A replacement Social Security card; or (3) A change of information on your record. [PDF]
Application for Payment of Medicare Premiums, Coinsurance and Deductibles [PDF]
The PA 600M is a mail-in application for payment of the Medicare Part B premium only. It is used to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare Part B premium. A face-to-face interview is not required when using this application. The application cannot be used to apply for Medicaid (Medical Assistance), cash assistance or food stamps. (PA 600 M (AS) 8/19)
Apply Online For Social Security Retirement Benefits
The Social Security Retirement benefit is a monthly check that replaces part of your income when you reduce your hours or stop working altogether. It may not replace all your income so it's best to identify other ways to pay for your monthly expenses as you age.
Benefits Check Up for Seniors
BenefitsCheckUp® connects millions of older adults and people with disabilities with benefits programs that can help pay for health care, medicine, food, utilities, and more.
Benefits Eligibility Screening Tool (BEST)
On SSA BEST, you can use the Benefit Eligibility Screening Tool (BEST) to find Social Security benefits you may be eligible to receive. It is not an application for benefits and will not send you free money.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Consumer Law Forms from Aging Safely
Aging Safely has developed a set of three consumer law forms that can be used as standalone letters or work together as a package to help older adults who have been victims of financial exploitation or identify theft: (1) Letter to a creditor to request debt forgiveness when a bill is owed; (2) Letter to a creditor to dispute a charge from a bank or company; and (3) Letter to a credit bureau to dispute an item on a credit report.
Cover Sheet for Interstate Enforcement of a Protection Order from Aging Safely
Aging Safely has created this free program that can create a cover sheet for your protection order when traveling outside your area of residence. When you put the cover sheet on top of your protection order, it makes it easier for the courts and police in other states to enforce your order.
Medical Assistance Financial Eligibility Application for Long-Term Care Supports and Services
Application for a determination of financial eligibility for long term care facilities. (PA 600-L Form) The person who needs help to pay for nursing facility care, or someone acting on his behalf, may complete the form.
Online Services: Apply For Retirement, Disability or Medicare Benefits and Other Services from the Social Security Administration
From the webpage of the Social Security Administration, you can apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and more – from anywhere and from any of your devices!
Safety Planning Form from Aging Safely
Aging Safely has developed this online interview that will help you prepare a free safety plan if you or a loved one are in an unsafe situation.
Social Security Benefit Application - Medicare
Online Medicare application from the Social Security Administration.
Custody Proceedings - Representing Yourself: Forms and Information from the Pennsylvania Courts
Free online information is available from the Pennsylvania Courts website to assist the growing number of Pennsylvanians who want to file their own family law cases in courts across the state. Standardized court forms for child custody proceedings may be obtained on this page of the Unified Judicial System of Pennsylvania’s website. Included are forms for both parents and third parties, including grandparents.
Federal Court Finder
Find a federal court location by location or court name, including appellate, district, bankruptcy, probation and pretrial office, or federal defender organization. Each District Court has its own local forms which are generally available on the Court website.
Hospital Compare - A quality tool provided by Medicare
This tool from the U.S. Department of Health and Human Services provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide.
How to Complete a Custody Complaint Form - For Grandparents and Third Parties (Video)
This video from Summit Legal Aid, formerly Laurel Legal Services. provides line-by-line instructions on how to complete a Custody Complaint form 2 (for grandparents and third parties) that is available from the PA Courts "Representing Yourself" website. (2020) Summit Legal Aid was formed when Southwestern Pennsylvania Legal Aid and Laurel Legal Services merged into a single legal aid program on July 1, 2023.
How to File a Case in Philadelphia Small Claims Court
You can bring a lawsuit for less than $12,000 in Small Claims Court, which is part of the Philadelphia Municipal Court. This is an explanation of the Small Claims Court process in Philadelphia from Philadelphia Legal Assistance, as outlined in a brochure from the Philadelphia Municipal Court.
Medicare Drug Plan Finder
The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.
Medigap Policy Search
This interactive tool from the Centers for Medicare & Medicaid Services helps you Find a Medigap Policy in Your Area.
Request for Social Security Earnings Information
This form will request verification of employment dates from the Social Security Administration. You may need this if you are having difficulty obtaining dates of employment for a pension, social security application, or personal reason. Please note: fees apply depending on the number of years you are requesting. [PDF] (02-2021) FREE yearly totals of earnings are available at www.ssa.gov/myaccount. (11/20224)
Social Security Retirement Estimator
The Retirement Estimator produces estimates that are based on your actual Social Security earnings record and has been rated the Federal Government's Best Online Service.
Upsolve
If you need to file Chapter 7 bankruptcy, you may be able to file your bankruptcy through Upsolve. Upsolve is a national non-profit that helps people file for Chapter 7 bankruptcy at no cost. Upsolve is an online program focused on assisting low-income Americans through Chapter 7 bankruptcy at no cost. Read about whether Chapter 7 bankruptcy is right for you!
How to Complete a Custody Complaint Form - For Grandparents and Third Parties (Video)
This video from Summit Legal Aid, formerly Laurel Legal Services. provides line-by-line instructions on how to complete a Custody Complaint form 2 (for grandparents and third parties) that is available from the PA Courts "Representing Yourself" website. (2020) Summit Legal Aid was formed when Southwestern Pennsylvania Legal Aid and Laurel Legal Services merged into a single legal aid program on July 1, 2023.
How to File a Case in Philadelphia Small Claims Court
You can bring a lawsuit for less than $12,000 in Small Claims Court, which is part of the Philadelphia Municipal Court. This is an explanation of the Small Claims Court process in Philadelphia from Philadelphia Legal Assistance, as outlined in a brochure from the Philadelphia Municipal Court.
PA Health Law Project Toll-Free Helpline - Call: 1-800-274-3258
The PA Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call the PHLP Helpline at 1-800-274-3258 or 1-866-236-6310 TTY or e-mail the PHLP at staff@phlp.org. Information from the PHLP is also available online at www.phlp.org. The Toll Free Helpline is open on Mondays and Wednesdays beginning at 8:00 AM Eastern.
Erie County: How to Get a Custody Order in Erie County
Information from the Erie County Bar Association about the steps involved in getting a custody order in Erie County. (February 2019)
Applying and Appealing for Disability at Social Security (Video)
Watch this video from CTLawHelp.org to learn about how to apply and appeal for disability at Social Security. This video covers federal laws so the information in it is true no matter what state you live in. (2013)
Apply Online For Social Security Retirement Benefits
The Social Security Retirement benefit is a monthly check that replaces part of your income when you reduce your hours or stop working altogether. It may not replace all your income so it's best to identify other ways to pay for your monthly expenses as you age.
COMPASS
COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information, including SNAP, TANF, Medicaid, LIHEAP and other social service programs.
Custody Proceedings - Representing Yourself: Forms and Information from the Pennsylvania Courts
Free online information is available from the Pennsylvania Courts website to assist the growing number of Pennsylvanians who want to file their own family law cases in courts across the state. Standardized court forms for child custody proceedings may be obtained on this page of the Unified Judicial System of Pennsylvania’s website. Included are forms for both parents and third parties, including grandparents.
Divorce Proceedings - Representing Yourself: Forms and Information from the Pennsylvania Courts
Free online information is available from the Pennsylvania Courts website to assist the growing number of Pennsylvanians who want to file their own family law cases in courts across the state. Standardized court forms for divorce proceedings may be obtained on this page of the Unified Judicial System of Pennsylvania’s website.
Hospital Compare - A quality tool provided by Medicare
This tool from the U.S. Department of Health and Human Services provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide.
Medical Assistance Financial Eligibility Application for Long-Term Care Supports and Services
Application for a determination of financial eligibility for long term care facilities. (PA 600-L Form) The person who needs help to pay for nursing facility care, or someone acting on his behalf, may complete the form.
Medicare Drug Plan Finder
The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.
Medigap Policy Search
This interactive tool from the Centers for Medicare & Medicaid Services helps you Find a Medigap Policy in Your Area.
Online Services: Apply For Retirement, Disability or Medicare Benefits and Other Services from the Social Security Administration
From the webpage of the Social Security Administration, you can apply for retirement, disability, and Medicare benefits online, check the status of an application or appeal, request a replacement Social Security card (in most areas), print a benefit verification letter, and more – from anywhere and from any of your devices!
Request for Social Security Earnings Information
This form will request verification of employment dates from the Social Security Administration. You may need this if you are having difficulty obtaining dates of employment for a pension, social security application, or personal reason. Please note: fees apply depending on the number of years you are requesting. [PDF] (02-2021) FREE yearly totals of earnings are available at www.ssa.gov/myaccount. (11/20224)
Social Security Benefit Application - Medicare
Online Medicare application from the Social Security Administration.
Survivors Planner: Planning For Your Survivors
Information from the Social Security Administration about help it can provide for your survivors when you die if you have earned enough Social Security credits through your work.
Upsolve
If you need to file Chapter 7 bankruptcy, you may be able to file your bankruptcy through Upsolve. Upsolve is a national non-profit that helps people file for Chapter 7 bankruptcy at no cost. Upsolve is an online program focused on assisting low-income Americans through Chapter 7 bankruptcy at no cost. Read about whether Chapter 7 bankruptcy is right for you!
Carbon Self Service Center - Forms
Download forms and information from the Carbon County Court of Common Pleas
Erie County: How to Get a Custody Order in Erie County
Information from the Erie County Bar Association about the steps involved in getting a custody order in Erie County. (February 2019)
Northampton County: Protection From Abuse Information
Information on Protection From Abuse services in Northampton county. Under the Protection From Abuse Act, you may file for an order if the person who has or is trying to harm you is/was your spouse; was living with you in a common-law marriage or as your boyfriend/girlfriend; the parent of your child; your child; was a sexual or intimate partner; your parent; or related to you by blood or marriage.
How to File a Case in Philadelphia Small Claims Court
You can bring a lawsuit for less than $12,000 in Small Claims Court, which is part of the Philadelphia Municipal Court. This is an explanation of the Small Claims Court process in Philadelphia from Philadelphia Legal Assistance, as outlined in a brochure from the Philadelphia Municipal Court.
Philadelphia Court of Common Pleas Forms Center
Forms available from the Philadelphia County Court of Common Pleas