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Download a Review and Continued Enrollment 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.
- Review and Continued Enrollment Form (English) 542 KB
- Review and Continued Enrollment Form (Spanish) 613 KB
- Review and Continued Enrollment Form (Chinese) 554 KB
- Review and Continued Enrollment Form (Korean) 529 KB
- Review and Continued Enrollment Form (Vietnamese) 627 KB
After you download and fill out the Review and Continued Enrollment form, mail to:
Healthy Families/Medi-Cal for Children & Pregnant Women
P.O. Box 138005
Sacramento, CA 95813-8005