WebCounty of Los Angeles DPSS. © 2024 DPSS Site. All rights reserved WebOnce this form is complete please email to: [email protected] Call HealthSource Integrated Solutions Program a dministration s upport to discuss referral: 785- 291- 9138 …
Forms - Alphabetic List - California Department of Social …
WebMay 22, 2024 · If additional information is necessary, a DPSS case worker will reach out to individual members. If the information has not been updated within the 30-day time frame, members may follow up with DPSS (toll free) at 1-866-613-3777. To check information has been updated, members can call DPSS or L.A. Care Customer Solutions Center. WebFeb 10, 2014 · 3. RFTHI Form - This is the main an nual redetermination form. One of these forms must be completed, or the information must otherwise be provided, by each member of the household; however, only the head of household must complete Section 9 and sign the form. 4. RFTHI Supplemental Form – This form supplements the RFTHI … project finance training courses
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WebRFA 00A (2/17) - Conversion - Resource Family Application. RFA 01A (10/22) - Resource Family Application. RFA 01B (5/21) - Resource Family Criminal Record Statement. RFA 02 (3/22) - Resource Family Background Checklist. RFA 03 (8/22) - Resource Family Home Health And Safety Assessment Checklist. Web7. 8. My DPSS. My Applications. My Calendar. You must be logged in to access this tab. WebDIRECT DEPOSIT AUTHORIZATION SIGN-UP FORM - PARTICIPANTS Department of Public Social Services To sign up for direct deposit, the payee is to read the back of this form and fill in the information requested in Sections 1 and 2 to convert your case to direct deposit. Please print and fill this form out completely. project finance youtube