CDSS IHSS Forms for Recipients

Health Care Certification SOC 873

Change of Address/Telephone SOC 840

You may hand deliver the "Change of Address" form to your Social Worker, or deliver it to our offices at 500 Westridge Drive, Watsonville, CA 95076 or 1400 Emeline St., Santa Cruz CA 95060.
You may also mail the "Change of Address" form to: IHSS P. O. Box 1320 Santa Cruz, CA 95061.

Change of Address and/or Telephone SOC840 form (includes return address)

Consumer and Provider Job Agreement

Assignment of Authorized Hours to Providers Form SOC 838