If you qualify as a legally-protected health care worker who provides gender-affirming care or reproductive care, you may apply to participate in the Address Confidentiality Program (ACP).
As an ACP participant, you will receive an alternate address to use when interacting with state and local government agencies, such as the Registry of Motor Vehicles, to prevent the creation of new public records listing your actual address. You will also be eligible for confidential voter registration, to keep your name off public voter rolls.
Please note: Health care providers who apply to ACP are not required to relocate as a condition of acceptance. If you do not relocate, ACP cannot protect against prior disclosures of your address.
Follow the steps listed below to apply to participate in ACP as a health care provider.
To qualify, you must be engaged in providing, facilitating, or promoting legally-protected health care activity. This includes gender-affirming care and reproductive health care services.
See Section 1 of the ACP Health Care Application for details on eligibility of applicants and covered health care activities.
An application designed for use by health care providers is provided below. This application should not be used by other ACP applicants, including those who are survivors of domestic violence, sexual assault, and stalking.
Complete the application according to the instructions provided on in Section 1, on the first page of the application. Print the form, sign the affidavit by hand, and enclose a copy of identification for any adult applicants in the household. For minors, enclose a copy of a birth certificate.
Do not email your application. Applications will only be accepted by mail.
ACP will contact you if your application is approved.
Click here to download the ACP Health Care Application (PDF)