Ihss provider application form 2026

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The document provides detailed information about the IHSS Program Provider Enrollment Form (SOC 426) required for individuals wishing to become or continue as IHSS providers in California. It outlines who must complete the form, the importance of signing it under penalty of perjury, the necessary identification required, and the implications of criminal convictions on eligibility. Additionally, it explains the process for submitting the form, potential disqualifying crimes, and the appeal process for those found ineligible.

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Click ‘Get Form’ to open the ihss provider application form (SOC 426) in the editor.
Begin with PART A, where you will need to provide your personal information. Ensure all fields are filled accurately to avoid delays.
Move on to PART B. Answer all parts of item #9 (a., b., and c.). If you answer 'YES' to any part, complete the remaining questions (#10, 11, 12, and 13) as required.
In PART C, read the declaration carefully. You must sign this section to confirm that you understand and agree to the statements under penalty of perjury.
Once completed, save your document. You will need to return it in person along with two original pieces of ID as specified in the instructions.

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soc 426 form

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