Email My Worker

Consent*
EHSD uses secure encryption to ensure your privacy and protect your data. You will receive a confirmation e-mail after you submit your information. Data you submit through this form will not be available on ehsd.org or any publicly accessible systems.
I agree to the privacy policy.
SMS Consent*
I agree to receive SMS messages from EHSD

Choose from the options below for your CalFresh or Medical case only:*
- I need to open a case with Contra Costa County
- I have a pending (not yet approved) CalFresh or Medical application in Contra Costa County
- I have a current open CalFresh or Medical case in Contra Costa County
- I have an open case outside Contra Costa County
Let us help you apply:

Online - MyBenefitsCalWin
Telephone - (877) 505-4630

Return to Help Page
Please contact your current county for assistance with your case.

Please visit the California Department of Heath Care Services website for county contact information

Return to Help Page

Confirmation Number
Date for Confirm #
Hidden field used to configure date mergetag output to confirmation number
Date Format: MM slash DD slash YYYY
Name*
First Last
County Case Number
Your case number is located at the top of any Notice of Action you have received in the mail from Contra Costa County and looks like 1F12345
If you do not know your case # please provide as much info as possible.
Your Date of Birth (DOB)*
Date Format: MM slash DD slash YYYY
Do You Have a Social Security Number (SSN)?*
- Yes
- No
Last 4 digits of SSN
Phone*
I would like to receive a one-time SMS confirmation message*
- Yes
- No
Do you have an email address?*
- Yes
- No
Email
Enter Email Confirm Email

I would like to upload an image to send to my worker*
- Yes
- No
Upload your image(s) below:
There is a 2MB file size limit and maximum of 3 files per submission
Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, tif, tiff, doc, docx, xls, xlsx.
Phone
This field is for validation purposes and should be left unchanged.