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REVISEDALAMEDA COUNTYHEALTH CARE SERVICES AGENCY COLLEEN CHALK, DirectorAGENDA October 1, 2019, OFFICE OF THE AGENCY DIRECTOR 1000 San Leandro Blvd., Suite 300 San Leandro, CA 94577 TEL (510) 6183452

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PDF health care is a form that individuals or entities must file to report their health care information.

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Employers who provide health care coverage to their employees are required to file PDF health care forms.

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Information such as the name, address, and social security number of the individual receiving health care coverage must be reported on PDF health care forms.

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