Client Concerns

* Indicates a required field

To submit a concern, please fill out the form and hit the 'submit' button.

Subject:

Concern:

First name

Last Name:

Phone Number:

Example: (555) 555-5555

Social Security Number:

Example: 000-00-0000

Benefit:

Medi-Cal

CalWORKs

CalFresh (formerly Food Stamps)

Cal-Learn

General Assistance

IHSS

Welfare-to-Work

Cash Assistance Program for Immigrants (CAPI)

Foster Care

Other