The following are Initial Health Assessment forms for you to complete before seeing your Wesley Health Centers doctor. Please click the one that applies to you and bring it to your visit.
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(866) SEE-JWCH | (866) 733-5924
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For questions regarding your eligibility, or assistance with your Medi-Cal Re-Determination Form, please contact our Member Service Department at (866)733-5924 or (562)867-7999
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