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  10. IHSS Forms & Documents

IHSS Forms & Documents

  1. IHSS Handbook (PDF)
  2. Address and/or Telephone Change, SOC 840 (PDF)
  3. Authorized Tasks (PDF)
  4. Communicating with Your Provider (PDF)
  5. Communicating with Your Recipient (PDF)
  6. Consumer and Provider Job Agreement (PDF)
  7. Exemptions (PDF)
  8. Filling out a Timesheet (PDF)
  9. Finding, Interviewing, and Hiring a Provider (PDF)
  10. Getting Started with Your New Provider (PDF)
  11. Live-In Provider Self-Certification Information (PDF)
  12. Mandated Reporter (PDF)
  13. Medi-Cal Fraud and Abuse (PDF)
  14. Paramedical Services (PDF)
  15. Provider Orientation Guide (10.5MB PDF)
  16. Services Covered by IHSS (PDF)
  17. Setting and Maintaining Boundaries (PDF)
  18. Share of Cost (PDF)
  19. Suggestions on How to Handle Money (PDF)
  20. Supervising Your Provider (PDF)
  21. Travel Time (PDF)
  22. Violations (PDF)
  23. Wait Time (PDF)
  24. Workweek Scheduling (PDF)
  25. DHHS Crisis Support Services (PDF)
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Contact Us

  1. In-Home Supportive Services

    Ph: 707-476-2100
    Ph: 866-527-8614

    808 E St.
    Eureka, CA 95501

    Lobby hours

    Monday - Friday
    8 a.m. - noon and 1 - 5 p.m.

    Payroll hours

    Monday - Thursday 
    8:30 - 11:45 a.m. and noon - 4:45 p.m.
    Friday 8:30 - 11:45 a.m.

  1. In-Home Supportive Services
  2. IHSS Public Authority
  3. IHSS Provider Enrollment
  4. IHSS Advisory Board
  5. IHSS Eligibility
  6. IHSS Forms & Documents

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    Contact Info and Links

Contact Us

  1. Humboldt County
    825 5th Street
    Eureka, CA 95501
    Phone: Staff Directory

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  1. Board of Supervisors
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  6. Measure Z
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