Wednesday, June 28, 2017

CDSS IHSS Forms for Recipients

Health Care Certification SOC 873

Change of Address/Telephone SOC 840

Hand deliver the  "Change of Address" form to your Social Worker or mail to: IHSS P. O. Box 1320 Santa Cruz, CA 95061 or deliver to our offices at 18 W. Beach St., Watsonville, CA 95076 or 1400 Emeline St., Santa Cruz CA 95060.

Change of Address and/or Telephone SOC840 form (Updated to include return address)

Consumer and Provider Job Agreement

Assignment of Authorized Hours to Providers Form SOC 838