SOC 838 I understand that by completing and submitting this form to the county In-Home Supportive Services (IHSS) program, I am requesting the IHSS program to assign the indicated number of my authorized hours to the named provider
Recipient Forms - Department of Public Social Services If you need assistance completing any of these forms, please contact the IHSS Helpline at (888) 822-9622 You have the right to interpreter services provided by the County at no cost to you
SOC 838. pdf - Los Angeles County, California I understand that by completing and submitting this form to the county In-Home Supportive Services (IHSS) program, I am requesting the IHSS program to assign the indicated number of my authorized hours to the named provider
IHSS Forms - Personal Assistance Services Council SOC 332 In-Home Supportive Services Recipient Employee Responsibilities Checklist SOC 426A In-Home Supportive Services Program Designation of Provider SOC 838 In-Home Supportive Services Recipient Request for Assignment of Authorized Hours to Provider
Forms | Contra Costa IHSS Public Authority Elective State Disability Insurance form (Applies to Parent Providers, Spouse Providers and Children under 18 providing services to a parent) Recipient request for assignment of authorized hours to providers