SOC 295 and SOC 873 Together: The IHSS Starter Pair

Why these two pages belong in the same envelope

Adult children often print one form and wait on the other. The file then sits. SOC 295 tells the county who is applying and how to reach them. SOC 873 is the Health Care Certification. CDSS says that certification, or acceptable alternative documentation, must reach the county before services are authorized. Treat them as a pair even if the office will stamp the application first.

This guide does not replace the field-by-field pages. It is the joint path: who signs which page, what to send with them, and what happens after the county has both. What to send with the application and how to get SOC 873 signed stay linked at the bottom.

Who appears on each form

The applicant on SOC 295 is the person who needs care, not the adult child organizing the packet. Use the name that already appears on Medi-Cal when you have one. A name mismatch is a common reason a file comes back. Helper or contact fields are where you put yourself.

SOC 873 is completed by a licensed health professional. You can carry the blank page to a clinic, a hospital discharge desk, or the clinician the person already sees. You do not complete the medical certification yourself. If a clinician offers a letter instead, ask the county whether that counts as acceptable alternative documentation.