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ALAMEDA COUNTY HEALTH CARE FOR THE HOMELESS 1404 Franklin Street, Suite 200 Oakland, CA 94612 TEL (510) 8918950 FAX (510) 8322139 www.achch.orgAlameda County Health Care for the Homeless Commission

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Anyone who requires medical care, treatment, or health insurance coverage may need to fill out a health care form. This includes individuals seeking regular medical check-ups, individuals applying for health insurance, patients seeking medical treatment or hospitalization, and those in need of government assistance or medical benefits.

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The health care form is a form used to report information about an individual's health care coverage.

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Individuals who have health care coverage are required to file the health care form.

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