Each item listed below is required at the time of your appointment in order to process your application.  Your appointment will be rescheduled if any of these items are missing.

¨   State application form CDPH 9042

¨   Proof of residency. This can be any of the following items: a copy of last month’s rent, mortgage, or utility bill listing your name and physical address within the county. P.O. Box addresses are not acceptable as proof of residency

¨   Physician’s letter or form CDPH 9044

¨   Medi-Cal Card, if applicable

¨   A valid government-issued identification card such as your California driver’s license or California Identification Card

¨   The application fee in a form of Money Order
or Cashier’s Check made out to Solano County for $200 for non Medi-Cal clients.  Medi-Cal members’ fee is $100.