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Now Available: Single Streamline Application Order Form

June 6, 2017

Presumptive Eligibility for Pregnant Women (PE4PW) and Hospital Presumptive Eligibility (HPE) providers are required to provide applicants the Single Stream Application (SSApp). Instead of printing the SSApp, providers can order a supply of SSApps online at no cost by using the Medi-Cal Order Form (MC 0026) (English and Spanish). The MC 0026 form can be downloaded from the Medi-Cal Eligibility Division (MCED) MC 0001 – 0999 Forms page of the Department of Health Care Services website.