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LOS ANGELES COUNTY DEPARTMENT OF HEALTH SERVICES MY HEALTH LA Day, Date Member ID: Member ID# Applicants Name Street Address Cityscape, Zip CodeImportant News about My Health LA Participants Aged
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Obtain a Welcome to Form LA document from the appropriate organization or authority.
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Fill out the personal information section, including your name, address, contact information, and any other required details.
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Provide information about your reason for visiting or moving to LA, if applicable.
04
Sign and date the form where indicated.
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Submit the completed form to the relevant department or individual, as per their instructions.

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01
Anyone who is new to the city of LA and needs to officially declare their arrival or intention to reside there.
02
Visitors, immigrants, students, and anyone else required to register their presence in LA.
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