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Registry Provider Application

Steps

  1. 1. Step One
  2. 2. PREFERENCES
  3. 3. Page 3
  4. 4. Page 4
  5. 5. Page 5
  6. 6. Page 6
  • Step One

    1. Placer County In-Home Supportive Services Public Authority Registry Application

    2. Instructions

      If you already have a recipient you want to work for, this is NOT the process to become an IHSS provider. Call 530-889-7115 and ask for the enrollment department. If you are seeking a recipient, please complete all areas of the application. Once we have received your completed application, we will contact you to schedule your Registry interview.

    3. Select One