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Additional Resources
Provider Forms
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Provider Forms
- DE-4 - Employee's Withholding Allowance Certificate (State)
- W-4 - Employee's Withholding Allowance Certificate (Federal)
- GEN 1365 - Notice of Language Services
- Overtime and Travel Time Information Flyer
- SOC 426 - In-Home Supportive Services Provider Enrollment Form
- SOC 829 - In-Home Supportive Services Provider Direct Deposit Enrollment/Change/Cancellation Form
- SOC 840 - In-Home Supportive Services Program Provider or Recipient Change of Address and/or Telephone Form
- SOC 846 - In-Home Supportive Services Program Provider Enrollment Agreement
- SOC 847 - Important Information For Prospective Providers - IHSS Provider Enrollment Process
- SOC 2255 In-Home Supportive Services (IHSS) Program Provider Workweek & Travel Time Agreement
- SOC 2279 - In-Home Supportive Services (IHSS) Program Live-In Family Care Provider Overtime Exemption
- SOC 2298 - In-Home Supportive Services (IHSS) Program and Waiver Personal Care Personal Services (WPCS) Live-In Self-Certification Form for Federal and State Wage Exclusion
Services Locator
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Services Locator
Find the LA County services and facilities that serve your area...