Steps for enrollment

Below you'll find a downloadable form to complete prior to your scheduled appointment. 

Visit our location and complete admission packet for potential participant. Please bring bring the application along with you to the appointment.

• Some form of accepted identification 
• Social Security Card/Number
• Proof of insurance 
• Application Form 
• Cal-Fresh (if applicable) 

• Participant will need a current negative TB result 
• Signed authorization from PCP. 

We will contact you if we need further documentation or information. It may take up to three weeks to be approved through the insurance and begin services. 

Who can join? 

• We serve the geriatric community, 65 and older and individuals with chronic conditions. 

What insurances are covered?

• Central California Alliance for Health 
• Veteran Affairs