Los Angeles County Area Agency on Aging 2026

1. Click ‘Get Form’ to open the Los Angeles County Area Agency on Aging Universal Intake Form in the editor.
2. Begin by filling in your personal information in the 'IDENTIFICATION' section. Include your last name, first name, middle initial, date of birth, and contact details such as home address and phone numbers.
3. Proceed to indicate your gender and rural designation. This helps the agency understand your demographic better.
4. In the 'DEMOGRAPHICS' section, select your race, ethnicity, relationship status, and type of residence. Be sure to answer all relevant questions for accurate service provision.
5. Complete the 'EMERGENCY CONTACTS' section by providing details of individuals who can be contacted in case of an emergency.
6. Fill out the 'BENEFITS' section to disclose any benefits you currently receive. This information is crucial for determining eligibility for services.
7. Finally, review all sections for accuracy before submitting. Use our platform's features to save or print a copy for your records.

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