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Forms & Applications
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Public Assistance Forms
Here you can access and download CalWORKs documents, CalFresh forms, Medi-Cal applications, Welfare-to-Work brochures, and more.
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Homeless Services Forms & Document
View or download intake and exit forms, status assessment, vulnerability index tool, release of information, and privacy notices. For groups participating in the Napa County Homeless Management Information System (HMIS).
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Reporting Communicable Disease Forms
See information about reporting diseases, such as requirements for individuals as well as health care clinics or laboratories. Access important telephone and contact information to report.
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HIV / AIDS Reporting & Surveillance
Reports from health care providers in Napa County are collected and processed according to the Centers for Disease Control and Prevention (CDC) and the Office of AIDS guidelines.
Forms & Applications
- Approved Provider of Prehospital Continuing Education (CE) Application (PDF)
- English Public Authority Registry Application (PDF)
- IHSS Health Care Certification Application (PDF)
- Public Health Nursing and Perinatal Outreach Educator Referral Form (PDF)
- Spanish Public Authority Registry Application (PDF)
- Suspected Child Abuse Repoting Form (PDF)
- Suspected Elder Abuse Reporting Form (PDF)