Health Care and Resource Fair Registration November 19, 2021 10:00-11:30 AM
Join us for an informational workshop on Medi-Cal, My Health LA and Covered California. The workshop will also include information about low-cost internet and Cal-Fresh.
Únase a nosotros para un taller informativo sobre Medi-Cal, My Health LA y Covered California. El taller también incluirá información sobre Internet de bajo costo y Cal-Fresh.
Sign in to Google to save your progress. Learn more
Name/Nombre *
Phone Number/Número de Teléfono *
Email/Correo Electrónico *
Student/Estudiante *
School/Escuela *
Do you want to enroll in Medi-Cal, My Health LA or Covered CA?/¿Desea inscribirse en Medi-Cal, My Health LA o Covered CA? *
Required
Do you want to apply for low-cost internet?/¿Quieres solicitar internet de bajo costo? *
Required
Do you want to enroll in Cal-Fresh?/¿Desea inscribirse en Cal-Fresh? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Paramount Unified School District. Report Abuse