Other Step 1 of 5 20% I have an open CalFresh (food stamps) or MediCal case:*I have a current open case in Contra Costa CountyI have a open case outside Contra Costa CountyI need to open a case with 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 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. Confirmation NumberDate 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 NumberYour 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)?*YesNoLast 4 digits of SSN Phone*Do you have an email address?*YesNoEmail Enter Email Confirm Email Detail your change, suggestion, request or question:*I would like to upload an image to verify my change*YesNoAttach your image(s) below:There is a 5MB file size limit Drop files here or Accepted file types: jpg, jpeg, gif, png, pdf, tif, tiff, doc, docx, xls, xlsx. Do you need to report an additional change?*YesNoEmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
