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HS Contact Request
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Contact Request
My issue/concern is regarding:
Value is not selected
-- Select one --
CalWORKs
CalFresh
Medi-Cal/Health Coverage
Employment Services
General Relief
Housing Authority
Veteran Services
Temporary Homeless Assistance
Insert Message here:
Upload document/image here: (** Be sure to include your case number on all documents you submit **)
Form field Upload document/image here: (** Be sure to include your case number on all documents you submit **) has
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Please enter your email address:
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Email
form field Please enter your email address:
is not in correct form
If your issue/concern was not reflected in the drop-down please refer to the Placer County website to determine the appropriate department or division. Thank you!
Email Address:
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