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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
You should contact the Compliance Department promptly by one of the following methods: Send an email via AHS global address “Compliance AHS” • Call the Compliance Department at 510-535-7788; or • Call the Compliance Hotline 844-310-0005, including reporting concerns anonymously.
For any questions or information regarding Medi-Cal health plans, visit or call a Health Care Options (HCO) representative at 1-800-430-4263.
For provider enrollment information visit our website at .alamedasocialservices and follow the directions for the Provider Enrollment Process, or call (510) 577-1877.