Form Dhcs 0008 - California Proof Of Citizenship And Identity Requirements - Health And Human Services Agency Page 3
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3State of California – Health and Human Services Agency
Department of Health Care Services
For a child under 16 who did not provide an Affidavit of
Citizenship, you may submit:
An Affidavit of the child’s identity signed by the child’s
parent, guardian, or caretaker relative with date and place
of birth
A Medi-Cal application or the Healthy Families/Medi-Cal
joint application that shows the child’s date and place of
birth, and is signed by the child’s parent, guardian, or
caretaker relative.
For a child under 18, an Affidavit of the child’s identity signed
by the child’s parent, guardian, or caretaker relative may be
used if school ID cards or driver licenses are not available.
Note: Expired identity documents are acceptable proof of identity.
DHCS 0008 (01/08)
Page 3 of 3
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