Schedule a Healthy Families Appointment

If you’d like to request a Healthy Families Assistant Appointment, please fill out the information below.

Please bring the following documents with you on the day of your appointment:

    Two (2) recent paycheck stubs (must be within 45 days, includes unemployment checks)
    Child(ren) birth certificates
    Proof of pregnancy
    Proof of any deductions (i.e. child support, child care expense, etc.)

Your Name (required)

Your Phone (required)

Do you prefer services in English or Spanish?
¿Prefiere los servicios en Inglés o Español?
 English Español

Do you want an appointment in Madera, Chowchilla, or in the Mountain Area?
¿Quieres una cita en Madera, Chowchilla, o Mountain Area?
 Madera Chowchilla Mountain Area

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