IMPORTANT: Are you enrolled in Medi-Cal? Has your contact information changed in the past two years? Give your county office your updated contact information so you can stay enrolled. Go to or call the Los Angeles County Department of Public Social Services at 1-866-613-3777

L.A. Care Health Plan Community Engagement Groups Interest Form

L.A. Care Health Plan wants to ensure our Community Engagement Groups represent the cultural, ethnic, and linguistic needs of L.A. County’s Medi-Cal population. We use this information to assess our effectiveness in recruiting a diverse pool of candidates.

Please complete the following information.