Print, Complete, and Bring These Required Enrollment Documents to Your Appointment

Provider Enrollment Checklist

Lista de Verificación de Inscripción de Proveedores

Phiếu Kiểm Tra Hồ Sơ Ghi Danh Người Chăm Sóc

Recipient Designation of Provider Form (SOC 426A)

Vietnamese SOC 426A

(The SOC 426A Form is applicable only if you are already providing services or planning to work for an IHSS Recipient.)

Note: If you are not working for an IHSS Recipient yet, you will be given a blank SOC 426A Form at your appointment for completion with your information. A return envelope will be provided so that you may submit the completed SOC 426A Form once you find an IHSS Recipient to work for.

Get fingerprinted before your appointment and bring the copy of your Live Scan Form

Live Scan Form

Live Scan Form Example

Live Scan Locations

If you do not have access to a printer, please call the Provider Enrollment Hotline at 714-825-3195 or email us at OCProviderEnrollment@ssa.ocgov.com and the necessary enrollment paperwork will be mailed to you.

Are all enrollment documents obtained?

CLICK HERE to Start Online Enrollment

Print, Complete, and Bring These Required Enrollment Documents to Your Appointment

IMPORTANT REMINDER:

Provider Enrollment Checklist

Provider Enrollment Checklist

Lista de Verificación de Inscripción de Proveedores

Phiếu Kiểm Tra Hồ Sơ Ghi Danh Người Chăm Sóc

Recipient Designation of Provider Form (SOC 426A)

English SOC 426A

Spanish SOC 426A

Vietnamese SOC 426A

Get fingerprinted before your appointment and bring the copy of your Live Scan Form

Live Scan Form

Live Scan Form Example

Live Scan Locations

If you do not have access to a printer, please call the Provider Enrollment Hotline at 714-825-3195 or email us at OCProviderEnrollment@ssa.ocgov.com and the necessary enrollment paperwork will be mailed to you.

You cannot continue without required enrollment documents

Are all enrollment documents obtained?

Print, Complete, and Bring These Required Enrollment Documents to Your Appointment

IMPORTANT REMINDER:

Provider Enrollment Checklist

Recipient Designation of Provider Form (SOC 426A)

Get fingerprinted before your appointment and bring the copy of your Live Scan Form

If you do not have access to a printer, please call the Provider Enrollment Hotline at 714-825-3195 or email us at OCProviderEnrollment@ssa.ocgov.com and the necessary enrollment paperwork will be mailed to you.

You cannot continue without required enrollment documents

Are all enrollment documents obtained?

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