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Clients can be exempt if they are: Age 60 or older, Younger than age 16, or younger than age 19 and in school full-time, Pregnant, Caring for a child younger than age 2, Caring for a relatives child, Unable to do WTW activities because of a disability, and.
CalFresh Student Exemption Screening Form (CF6177) This is a form for students to pre-screen to see if they are eligible for CalFresh as a college student.
Authorization to Release Medical Information (CW 61) The CW 61 is used by ECs to determine if a client has a medical condition that would exempt him/her from CWES activities or limit his/her participation.
The document is a Support Questionnaire from the California Department of Social Services, designed for county use to gather information about noncustodial parents or unmarried fathers in relation to child support cases.
(a) Patients may authorize the release of their health care information by completing the CDCR 7385, Authorization for Release of Protected Health Information , to allow a family member or friend to request and receive an update when there is a significant change in the patient s health care condition.
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Comments: This form is intended to determine the extent, if any, that this persons current physical condition would interfere with his/her ability to work or participate in a CalWORKs activity.

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