[BFC] Covered CA + Medi-Cal Call-list
The Berkeley Free Clinic (BFC) offers free enrollment counseling services for Covered CA during enrollment period (November 1st-January 31st), as well as free assistance with Medi-Cal applications all-year round.

Please enter your information here and we will give you a call back in regards to your health insurance related concerns and/or sign you up for an appointment to enroll in a Covered CA insurance plan or in Medi-Cal.

Client Not Yet Contacted *
It's the only option, but please check the circle!
Date client contacted BFC *
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DD
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YYYY
How did the client contact us? *
Required
Client Name *
Your answer
Phone Number (XXX-XXX-XXXX)? *
Please write "NA" if you do not have one. You must provide at least one form of contact!
Your answer
Email Address? *
Please write "NA" if you do not have one. You must provide at least one form of contact!
Your answer
Which of the following times would you generally be available for an appointment? *
Please check all that apply.
Required
Notes: Please provide any other information you would like to share with us before we contact you. *
This may include but is not limited to: The best time and method to contact you, your current employment or health insurance situation details, what you are interested in getting out of the appointments, questions, etc.
Your answer
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