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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

      Must be 18 years old to apply.

    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. Please only apply once. If you feel you made errors or you would like to check the status of your application, please call or email [email protected] ***We are not currently accepting applications for the Tahoe region.***
    3. Select One
    4. Are you 18 years or older?