Downloads
Follow us!
Download an Authorized Representative Form
Most items are in Acrobat pdf format, and you will need Acrobat Reader to see them. Click
here
to download a free copy of Adobe Acrobat Reader if you do not have the program.
After you download and fill out the Authorized Representative form, mail to:
Healthy Families/Medi-Cal for Children & Pregnant Women
P.O. Box 138005
Sacramento, CA 95813-8005