• Stockton, San Rafael, San Ramon
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Inquiry Form – CalAim, Medi-Cal, and Enhanced In-Home Care Services

The page is designed to make the referral process simple and straightforward for our referral partners and families. To learn more about our Medi-Cal services, select the Medi-Cal tab in the menu. Submit your information today, and our team will review your request. Once we have reviewed your information, we’ll follow up with the next steps based on your needs and eligibility.

MEDI-CAL Client Referral Sheet

If you know of someone who might benefit from CalAIM Medi-Cal Services, please complete every section on this form and submit secure encrypted e-mail to: calaim@jmhomecare.com

This field is for validation purposes and should be left unchanged.
MM slash DD slash YYYY
MM slash DD slash YYYY

MEDI-CAL MRN And CIN Number (on ID Cards/Need Both Numbers)

MEDI-CAL Insurance Plan:(Required)
County Of Residence:(Required)

MEDI-CAL Service(s) Member Is Interested In: (Check ALL That Apply)

Enhanced Care Management (person-centered care planning and support):
Community Supports (caregiving support):

IHSS Status:

The client is aware that we are requesting services on their behalf and have consented to participate in the program:(Required)

If you would like MEDI-CAL Referral status updates please email: calaim@jmhomecare.com

Our Locations

  • North Bay
    77 Mark Dr #12,
    San Rafael, CA 94903
    HCO# 214700004
  • 415-233-9564 (Marin County)
    707-289-6960 (Sonoma & Napa County)

  • East Bay
    16 Crow Canyon Ct #200
    San Ramon, CA 94583
    HCO# 074700004
  • 925-243-7726

  • Central Valley
    3453 Brookside Rd # C
    Stockton, CA 95219
    HCO# 394700004
  • 209-208-4132 (Central Valley)
    916-943-4405 (Sacramento Area)
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